{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:53:14Z","timestamp":1788915194467,"version":"build-2803163510"},"reference-count":60,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Few studies have focused on sleep apnea and substance use disorders with co-occurrence of anxiety disorder and depression. This study included a total of 270,227 adults, 9268 with co-occurrence of anxiety disorder and depression in the past year, from the combined 2008\u20132014 National Survey on Drug Use and Health (NSDUH) data, which are the latest datasets with measures of anxiety disorder and sleep apnea. Weighted multinomial logistic regression analyses were used to estimate the associations between anxiety disorder and depression and their co-occurrence. Comorbidity was highly prevalent: 40.4% of those with depression also met the criteria for anxiety disorder, whereas 51.8% of those with anxiety disorder also met the criteria for depression. The prevalences of anxiety only and co-occurrence increased from 2008 to 2014. The prevalences of anxiety disorder only, depression only, and co-occurrence of anxiety disorder and depression in individuals with sleep apnea were 4.4%, 12.9%, and 12.2%, respectively, and the prevalences in substance use disorders were 6.4%, 9.4%, and 10.7%, respectively. The results showed that sleep apnea, substance use disorders, and nicotine dependence were significantly associated with increased odds of anxiety disorder, depression, and co-occurrence (all p values &lt; 0.0001). Furthermore, several chronic diseases (asthma, bronchitis, hypertension, and heart disease) were associated with the co-occurrence of anxiety disorder and depression. These findings suggest clinicians and other healthcare providers consider screening for depression and anxiety with sleep apnea and substance use disorders for improved therapeutic outcomes.<\/jats:p>","DOI":"10.3390\/brainsci13040661","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T10:29:16Z","timestamp":1681468156000},"page":"661","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sleep Apnea and Substance Use Disorders Associated with Co-Occurrence of Anxiety Disorder and Depression among U.S. Adults: Findings from the NSDUH 2008\u20132014"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7893-6341","authenticated-orcid":false,"given":"Chun","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscila","family":"Acevedo","sequence":"additional","affiliation":[{"name":"School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6798-3492","authenticated-orcid":false,"given":"Nianyang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD 20742, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaysie","family":"Ozuna","sequence":"additional","affiliation":[{"name":"Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4231-5847","authenticated-orcid":false,"given":"Saima","family":"Shafique","sequence":"additional","affiliation":[{"name":"School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7378-4311","authenticated-orcid":false,"given":"Annu","family":"Karithara","sequence":"additional","affiliation":[{"name":"Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Padilla","sequence":"additional","affiliation":[{"name":"Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxiang","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN 37614, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kesheng","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/978-981-32-9705-0_14","article-title":"Comorbid Anxiety and Depression: Clinical and Conceptual Consideration and Transdiagnostic Treatment","volume":"Volume 1191","author":"Choi","year":"2020","journal-title":"Advances in Experimental Medicine and Biology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"366","DOI":"10.5498\/wjp.v5.i4.366","article-title":"Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches","volume":"5","author":"Coplan","year":"2015","journal-title":"World J. 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