The Role of Pythagorean Self-Awareness Intervention in Obstructive Sleep Apnea. A Randomized Controlled Trial

Obstructive sleep apnea (OSA) is a chronic disease causing daytime sleepiness and poor sleep and life quality. So far, its repercussions on psychological health have been poorly addressed in the available literature. The aim of this study was to investigate the effect of a cognitive-based stress management technique, called the Pythagorean Self-Awareness Intervention (PSAI), in patients with OSA. In this randomized controlled (parallel usual care group) trial with a 1:1 allocation ratio, patients in the intervention group (N = 30, 59.7 ± 9.4 years old, 15 females) received PSAI for 8 weeks along with continuous positive airway pressure (CPAP) treatment, while patients in the control group (N = 30, 58.9 ± 9.3, 22 females) received CPAP alone. The primary endpoint included OSA symptoms. Secondary endpoints were sleepiness, sleep quality, depression-anxiety-stress, and affect. All 30 patients in the intervention group showed 100% compliance with PSAI. There was a statistically significant reduction in OSA symptoms in the intervention group compared to the control group (p = 0.021). With regard to secondary endpoints, there were statistically significant improvements in sleep quality (p = 0.001) and positive (p = 0.001) and negative affects (p < 0.001) in the PSAI group versus controls. No side effects were reported by the patients. PSAI may be useful as a complementary tool for the management of patients suffering from OSA. Larger randomized controlled trials are required to validate the results of this study.