0518 Association Between Obstructive Sleep Apnea and Psychiatric Symptoms in a Japanese Working Population

Abstract Introduction Obstructive sleep apnea (OSA) is reported to be linked to depression, anxiety, and insomnia, particularly in clinical populations. However, evidence from working, non-clinical populations remains limited. This study examined the association between home sleep apnea testing derived OSA severity and psychiatric symptoms among municipal employees in Japan. Methods We performed a cross-sectional study in a Japanese working population to identify the OSA severity associated with psychiatric symptoms based on the results of a questionnaire survey and home sleep apnea tests (HSAT). A total of 707 municipal employees underwent one-night home sleep apnea testing and completed various standardized instruments to evaluate depression (PHQ-9), anxiety (GAD-7), insomnia (AIS) and excessive daytime sleepiness (JESS). Logistic regression models (unadjusted, fully adjusted, sex-stratified, and shift-work-stratified) were used to examine associations between OSA severity and psychiatric outcomes. Dose–response models using OSA severity as an ordinal predictor were also conducted. Results Of the 1543 employees invited to participate, 1247 completed the questionnaire survey. Of those, 707 participants (58% female, 44.8 ±11.5 years) underwent HSAT and were eligible for analysis. Participants with moderate/severe OSA were older, had higher BMI, and shorter sleep duration compared with those without OSA. In unadjusted models, moderate/severe OSA was associated with lower odds of anxiety and insomnia. Fully adjusted models showed that moderate/severe OSA remained significantly associated with lower odds of depression, anxiety, and insomnia. Conclusion In this cohort of working-age municipal employees, HSAT-defined OSA was not associated with higher psychiatric symptom burden. Instead, moderate/severe OSA showed inverse associations with depression, anxiety, and insomnia driven mainly by men and non–shift workers. These results suggest caution in generalizing clinic-based OSA findings to healthy populations. Support (if any) This work was supported in part by research grants from the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. / MSD K.K., Eisai Co., Ltd., and SECOM Science and Technology Foundation. HK was associated with a laboratory that was supported by donations from Fukuda Lifetech Co., Ltd. and Fukuda Life Tech Keiji Co., Ltd. to Shiga University of Medical Science.