Wearable Devices to Assess Effects of Central Nervous Medications on Physical Conditions in Patients With Sleep Problems
Condition: Anxiety Disorders; Sleep Apnea
MeSH terms: Sleep Apnea Syndromes; Dyssomnias; Parasomnias; Anxiety Disorders
Study type: Observational

Summary: 
      Generalized anxiety disorder (GAD) and obstructive sleep apnea (OSA) are two common diseases
      and share similar symptoms such as anxiety, poor attention, and poor sleep quality. However,
      the evidence toward the association between GAD and OSA is limited. The current study aims to
      use wearable devices to detect comorbid OSA in newly diagnosed patients with GAD and observe
      the treatment response and difference in automatic nervous function in GAD and GAD/OSA
      groups.
    

Detailed description: 
      Background: The symptoms of a generalized anxiety disorder (GAD) included excessive anxiety,
      restlessness, fatigue, poor concentration, irritability, and poor sleep quality. GAD is
      frequently combined with depressive disorder and autonomic dysfunction and is one of the most
      prevalent psychiatric disorders in a psychiatric clinic. However, many of the symptoms of GAD
      are like the symptoms of obstructive sleep apnea (OSA), such as daytime fatigue, poor
      attention, and poor sleep quality. In addition, patients with OSA are easily comorbid with
      symptoms of anxiety and depression in retrospective studies. Nevertheless, there is limited
      data present on the comorbid of OSA in newly diagnosed patients with GAD. It is important to
      realize the comorbidities between OSA and GAD. Many of the benzodiazepines for GAD during
      sleep may worsen the severity of sleep apnea. Therefore, realizing the relationship between
      GAD and OSA is important for clinicians.

      Question/Hypothesis: We hypothesize that patients with newly diagnosed GAD have a high ratio
      of OSA comorbidity and those with both GAD and OSA have worse severity of anxiety symptoms
      and heart rate variability.

      Specific Aims: Current study aims to investigate 1) the prevalence of OSA in newly diagnosed
      patients with GAD; 2) the difference of heart rate variability and baseline characteristics
      between newly diagnosed patients with GAD and GAD with OSA; 3) the difference of
      antidepressant treatment response between newly diagnosed patients with GAD and GAD with OSA.

      Experimental design: This study aims to enroll 80 participants with GAD, 40 patients with
      newly diagnosed GAD and 40 newly diagnosed GAD comorbid with OSA by using a home sleep apnea
      test and used validated cloud-computing sleep apnea screening system. In addition, we would
      investigate the difference between baseline characteristics and heart rate variability among
      healthy participants, GAD, and GAD comorbid OSA. In addition, we also evaluate the difference
      in antidepressant treatment effect on GAD patients with and without OSA on week 2, week 4,
      and week 12.
    

Intervention name(s): Escitalopram
Intervention type(s): Drug
Intervention description(s): We use Escitalopram 5~10 mg for two groups to observe the impact of sleep apnea on the treatment of generalized anxiety disorder
Intervention MeSH terms: Escitalopram
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Taiwanese
      
Keywords: anxiety; sleep apnea