Associations of Undiagnosed Obstructive Sleep Apnea and Excessive Daytime Sleepiness With Depression: An Australian Population Study

Abstract

Study Objectives: To determine whether undiagnosed obstructive sleep apnea (OSA) and/or excessive daytime sleepiness are associated with symptomatic depression in Australian men. Methods: Participants were randomly selected, urban community dwelling men aged 40 to 88 years without a prior diagnosis of OSA. Clinically significant depressive symptoms were assessed using the Beck Depression Inventory-1A or Centre for Epidemiological Studies Depression Scale (2007)(2008)(2009)(2010). A random sample of men (n = 788) undertook full at-home unattended polysomnography (Embletta X100, Broomfield, Colorado, United States) and completed the Epworth Sleepiness Scale questionnaire (2010)(2011)(2012). Results: Undiagnosed severe obstructive sleep apnea (apnea-hypopnea index ≥ 30 events/h) was associated with depressive symptoms (adjusted odds ratio = 1.98; 95% confidence interval [CI] 1.05-3.73; P = .036). However, a significant interaction was observed between obstructive sleep apnea and excessive daytime sleepiness (P = .03) such that individuals with OSA and excessive daytime sleepiness (Epworth Sleepiness Scale score of 10 or higher) exhibited the strongest associations with depression (mild-moderate apnea: adjusted odd ratio = 3.86; 95% CI 1.87-7.95; severe apnea: adjusted odd ratio = 4.82; 95% CI 1. 42-16.35) when compared to individuals without apnea. Conclusions: Depressive symptoms in men were associated with undiagnosed OSA in the community. It is important that clinicians and primary care practitioners consider screening for depression in men with severe OSA and for OSA in men with depression. Screening for depression should also be considered in men with excessive daytime sleepiness regardless of OSA severity.

Pathophysiology of swallowing following oropharyngeal surgery for obstructive sleep apnea syndrome

“…Most of the patients had received the oropharyngeal surgery for treatment of severe OSAS, a clinical syndrome affecting at least 2%-4% of the adult population 28 and confirmed based on polysomnography during sleep. 16,29 Obstructive sleep apnoea syndrome can be treated with nonsurgical options such as continuous positive airway pressure, however, treatment compliance is often poor 30 leading to consideration of surgical options. The clinical benefits of surgery are now well established.…”

Association between sleep-related breathing disorder and depression in young adults and aged population - A survey

“…The limitation of this study was limited sample size. Other research in similar topics were done in larger sample sizes, for example 788 men aged 40 to 88 years were assessed for sleep apnea and depression (Lang et al, 2017).…”

Factors associated with undiagnosed obstructive sleep apnoea among hypertensive patients: A multisite cross‐sectional survey study in Taiwan

“…Excessive daytime sleepiness is a cardinal symptom of OSA, and it is considered one of the major reasons that patients with OSA decide to seek medical help (Broström et al., ; Lang et al., ). The possible mechanism for the association between OSA and EDS would be that OSA triggers hypopnoea and apnoea to produce hypercapnia, and hypercapnia induces cardiovascular autonomic change during sleep which further alters brainstem dysfunctions.…”