Journal of the American Association of Nurse Practitioners · 2026
Mediating effect of mood state on health-related quality of life among positive airway pressure users: Secondary analyses of Apnea Positive Pressure Long-term Efficacy Study data.
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Shapiro April L, Abucevicz-Swick Krystal, Wang Kesheng, Piamjariyakul Ubolrat
Аннотация
BACKGROUND: Positive airway pressure (PAP) remains the gold standard therapy for obstructive sleep apnea. Mood state negatively affects PAP tolerance, adjustment, and adherence and subsequent health-related quality of life (HRQOL).
PURPOSE: This secondary analysis examined complex relationships among sleep, mood state, and HRQOL variables from the Apnea Positive Pressure Long-term Efficacy Study (APPLES) national data set.
METHODOLOGY: Using Amos, structural equation modeling was conducted to examine the mediating effect of mood state on HRQOL among PAP and sham (subtherapeutic) PAP users ( N = 1,105).
RESULTS: Mood significantly mediated the relationship between sleep variables and HRQOL, including sleepiness (β = -0.07, p < .01) and sleep efficiency (β = 0.05, p < .01). Mood was the strongest HRQOL predictor in the model (β = -0.40, p < .01). Mood also significantly mediated the relationship between age (β = 0.08, p < .01), gender (β = -0.04, p < .05), Black ethnicity (β = 0.04, p < .05), marital status single (β = -0.05, p < .05), and HRQOL.
CONCLUSIONS: Mood significantly mediated the effects of sleepiness and sleep efficiency on HRQOL. Additional findings indicated potential health disparities related to PAP use, underscoring the need for personalized intervention strategies. Insights from this study highlight the importance of addressing mood state to improve PAP-related outcomes.
IMPLICATIONS: Understanding the relationship between mood and HRQOL among PAP users is essential in improving management strategies, including successful approaches to promote PAP tolerance, adjustment, and adherence. Future research to explore the PAP use-mood-HRQOL triad is warranted.
PURPOSE: This secondary analysis examined complex relationships among sleep, mood state, and HRQOL variables from the Apnea Positive Pressure Long-term Efficacy Study (APPLES) national data set.
METHODOLOGY: Using Amos, structural equation modeling was conducted to examine the mediating effect of mood state on HRQOL among PAP and sham (subtherapeutic) PAP users ( N = 1,105).
RESULTS: Mood significantly mediated the relationship between sleep variables and HRQOL, including sleepiness (β = -0.07, p < .01) and sleep efficiency (β = 0.05, p < .01). Mood was the strongest HRQOL predictor in the model (β = -0.40, p < .01). Mood also significantly mediated the relationship between age (β = 0.08, p < .01), gender (β = -0.04, p < .05), Black ethnicity (β = 0.04, p < .05), marital status single (β = -0.05, p < .05), and HRQOL.
CONCLUSIONS: Mood significantly mediated the effects of sleepiness and sleep efficiency on HRQOL. Additional findings indicated potential health disparities related to PAP use, underscoring the need for personalized intervention strategies. Insights from this study highlight the importance of addressing mood state to improve PAP-related outcomes.
IMPLICATIONS: Understanding the relationship between mood and HRQOL among PAP users is essential in improving management strategies, including successful approaches to promote PAP tolerance, adjustment, and adherence. Future research to explore the PAP use-mood-HRQOL triad is warranted.