Quality of Life, Mental Health, and CPAP Compliance in Thai Patients with Obstructive Sleep Apnea during COVID-19 Pandemic

Background. This study is aimed at determining the quality of life, mental health, and adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) among Thai OSA patients during the coronavirus disease 2019 (COVID-19) pandemic as this data has been lacking. Methods. A cross-sectional study was conducted at a university hospital between September 2021 and April 2022. OSA patients aged 18 years or older who required home CPAP treatment were included. Sleep Apnea Quality of Life Index (SAQLI) and Depression Anxiety Stress Scales-21 (DASS-21) were used to assess quality of life and mental health, respectively. Results. A total of 142 participants (62% male) were included, with a mean age of <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"><a:mn>54.4</a:mn><a:mo>±</a:mo><a:mn>14.7</a:mn></a:math> years and a body mass index of <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"><c:mn>29.9</c:mn><c:mo>±</c:mo><c:mn>6.8</c:mn></c:math> kg/m2. Polysomnographic data showed a mean apnea-hypopnea index of <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"><e:mn>48.0</e:mn><e:mo>±</e:mo><e:mn>32.4</e:mn></e:math> events/hour and a mean lowest oxygen saturation of <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"><g:mn>79.2</g:mn><g:mo>±</g:mo><g:mn>12.2</g:mn></g:math> %. Severe OSA was observed in 66.9%. CPAP compliance was reported in 50.7%. The SAQLI score was <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"><i:mn>2.32</i:mn><i:mo>±</i:mo><i:mn>1.12</i:mn></i:math> . Depression, anxiety, and stress scores in DASS-21 were <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"><k:mn>2.89</k:mn><k:mo>±</k:mo><k:mn>3.31</k:mn></k:math> , <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"><m:mn>3.94</m:mn><m:mo>±</m:mo><m:mn>3.67</m:mn></m:math> , and <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"><o:mn>4.82</o:mn><o:mo>±</o:mo><o:mn>4.00</o:mn></o:math> , respectively. Compared to the CPAP compliance group, the CPAP noncompliance group had higher daily activity scores in SAQLI ( <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"><q:mn>2.98</q:mn><q:mo>±</q:mo><q:mn>1.25</q:mn></q:math> vs. <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"><s:mn>2.45</s:mn><s:mo>±</s:mo><s:mn>1.33</s:mn></s:math> , <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M11"><u:mi>P</u:mi><u:mo>=</u:mo><u:mn>0.015</u:mn></u:math> ). Conclusions. The quality of life for Thai OSA patients during the COVID-19 era was moderate degree. Poor CPAP compliance was significantly associated with limited daily activity. Enhancing CPAP compliance could improve the quality of life in these patients. This trial is registered with TCTR20211104004.