1077 Early Improvements in Mental Health with PAP Therapy in OSA: A Large Patient Experience Survey

Abstract Introduction Individuals with obstructive sleep apnea (OSA) are at increased risk for mental health disorders including depression and anxiety. Positive airway pressure (PAP) is the first-line treatment for OSA, but its potential to mitigate mental health burden is not well studied. Thus, we evaluated the impact of PAP therapy on mental and emotional well-being and how outcomes differ by gender. Methods A cross-sectional study was conducted among adults (18+ years) residing in the United States and using PAP therapy (Resmed) for OSA treatment. Participants completed an online survey on pre- and post-therapy emotional well-being and mental health symptoms, as well as post-therapy time to perceived improvement. Changes in symptoms were rated on a 5-point Likert scale (1 = significantly worsened; 5 = significantly improved). Time to "significant” improvement was assessed using a time scale. Descriptive statistics were used to quantify outcomes for the overall sample with pre-symptoms accounting for any burden. Change analyses were limited to “significant” or “severe” pre-therapy responses, and “significantly improved” post-therapy responses. Standard comparative statistical analyses examined gender differences. Results 1,880 respondents were included in the analysis (mean age: 56.0 years, 54.6% female, 44.4% with severe OSA; 48% on PAP therapy < 30 days). High rates of pre-therapy mental health and emotional well-being symptoms were reported: stress (83.0%), irritability (81.1%), mood (75.9%), worry (75.7%), anxiety (74.6%), and depression (60.3%). Low motivation (17.2%) and general happiness (30.2%) were also reported. Females reported all pre-therapy symptoms at a greater frequency than males (all p< 0.001). Within the “first few days” of PAP initiation, respondents with a "significant" or "severe" symptom pre-therapy reported a “significant improvement” in stress (48%), irritability (46%), mood (50%), worry (50%), anxiety (56%), depression (37%), motivation (50%), and general happiness (54%). Continued symptom improvement was reported up to one-year post-therapy initiation, with no significant differences by gender (p>0.05). Conclusion PAP therapy was associated with early perceived mental health and emotional well-being. While females experienced higher rates of pre-therapy symptoms, there were no gender differences in improvements post-therapy nor in time to improvement. These findings may inform strategies to personalize OSA management and support continued PAP usage. Support (if any) Resmed