Depression, obstructive sleep apnea and psychosocial health

Jehan, Shazia; Auguste, Evan; Pandi‐Perumal, Seithikurippu R.; Kalinowski, Jolaade; Myers, Alyson; Zizi, Ferdinand; Rajanna, Madhu G; Jean‐Louis, Girardin; McFarlane, Samy I.

doi:10.15406/smdij.2017.01.00012

Cited by 18 publications

(3 citation statements)

References 91 publications

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“…DOCA has been linked to a decline in QOL in the general population [23,24]. The stroke-specific QOL scale (SS-QOL) evaluates various aspects such as energy levels, engagement in family activities and social roles, speech or language impairment, mobility and functioning, mood and personality, self-care ability, and changes in vision, cognition, and productivity [23].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Outcomes of Depression, Obstructive Sleep Apnea, and Concurrent Anxiety (DOCA) in Stroke Survivors: Insights From a Nationwide Study

Patel,

Rao,

Manihani

et al. 2023

Cureus

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Background: Many individuals will also experience psychological side effects after a stroke episode, such as symptoms of depression, anxiety (generalized anxiety disorder (GAD)), and/or specific phobias, considerably decreasing their quality of life (QOL). Objective: This study aimed to evaluate the prevalence of depression, obstructive sleep apnea (OSA), and concurrent anxiety (DOCA) and their outcomes (morbidity, disability (All Patient Refined Diagnosis Related Group (APRDRG) - loss of function), and discharge disposition) among acute ischemic stroke (AIS) hospitalizations. Methods: A cross-sectional study used the National Inpatient Sample (NIS) from 2003-2017. Adults with hospitalizations with AIS were extracted, and DOCA was identified using ICD-9/10-CM codes. Weighted analysis using a chi-square test and mixed-effect multivariable survey logistic regression was used to assess the prevalence and role of DOCA in predicting outcomes. Results: Out of 5,690,773 AIS hospitalizations, 2.7%, 3.1%, and 4.4% had depression, OSA, and GAD, respectively. In AIS patients, females had a higher prevalence of depression (3.4% vs. 2.3%) and GAD (5.9% vs. 3.0%) and a quality of life lower prevalence of OSA (2.2% vs 4.4%) in comparison to males (p<0.0001). Caucasians had a higher prevalence of depression, OSA, and GAD in comparison to others (African Americans/Hispanics/Asians/Native Americans). Depressed patients had a higher prevalence of morbidity (9% vs. 8% vs 5% vs. 7%), disability (46% vs. 46% vs. 35% vs. 37%), transfer to non-home (69% vs. 58% vs. 61% vs. 63%) in comparison with OSA, GAD, and non-DOCA patients, respectively (p<0.0001). Depression was associated with a 40% higher chance of severe disability (aOR 1.40; 95% CI 1.38-41), morbidity (1.36; 1.33-1.38), and discharge to non-home (1.54; 1.52-1.56). OSA and GAD had higher odds of non-home discharge amongst post-AIS hospitalizations. Conclusion: DOCA is associated with poor outcomes among post-AIS patients. Prompt recognition by screening and timely management of DOCA may mitigate the adverse outcomes.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Outcomes of Depression, Obstructive Sleep Apnea, and Concurrent Anxiety (DOCA) in Stroke Survivors: Insights From a Nationwide Study

Patel,

Rao,

Manihani

et al. 2023

Cureus

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“…These are important risk factors that should be considered in propensity score matching while building cohorts. The authors noted that all cohorts were matched for age, sex, and co-morbidities, but the large difference in co-morbidities in the CPAP group indicated that these patients likely had other co-morbidities and behavioral factors that were not considered [ 6 ]. While authors matched for many relevant comorbidities, the results may still be biased due to the nature of the retrospective study.…”

Section: Selection Biasmentioning

confidence: 99%

Letter to the Editor of Journal of Otolaryngology regarding “Risk of diabetes in patients with sleep apnea: Comparison of surgery versus CPAP in a long-term follow-up study”

Truong,

Sciscent,

Lorenz

et al. 2023

Journal of Otolaryngology - Head & Neck Surgery

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Obstructive sleep apnea (OSA) is associated with multiple chronic comorbidities with treatments including continuous positive airway pressure (CPAP), upper airway surgery (UAS), and hypoglossal nerve stimulation (HNS). Given the complexity of the condition and multiple treatment options, there is an ongoing debate to determine the best management. O’Connor-Reina et al. recently published a paper titled “Risk of diabetes in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study.” In their study, the authors stated that OSA patients who received surgery had a 50% less chance of developing diabetes compared to patients who only received CPAP treatment. However, we would like to point out some limitations that warrant attention and caution interpretation of the findings by physicians and patients.

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“…Patients with OSA have a higher prevalence of depression [12,65]. These depressive symptoms may gradually improve with CPAP treatment [66,67].…”

Section: Depressionmentioning

confidence: 99%

The many faces of obstructive sleep apnea

Carter

2023

Obstructive Sleep Apnea - New Insights in the 21st Century

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Obstructive sleep apnea is a common disorder with many different comorbidities. Patients can present with these comorbidities even when sleep apnea has not been diagnosed due to the low diagnostic rates for obstructive sleep apnea worldwide. This presents a concern for clinicians as unless sleep apnea is treated along with a presenting comorbidity, the patient will not have an optimal health outcome. This chapter addresses several of the most common and worrisome comorbidities of sleep apnea and discusses the relationships and pathophysiology of comorbidities including insomnia, treatment resistant hypertension, restless legs syndrome, depression, gastroesophageal reflux, asthma, cognitive disorder, REM sleep behavioral disorder and paroxysmal atrial fibrillation. Clinical studies documenting the relationships of each of these comorbidities to obstructive sleep apnea are presented with putative pathophysiologic discussion of how obstructive sleep apnea aggravates or leads to the development of each of these illnesses.

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Depression, obstructive sleep apnea and psychosocial health

Cited by 18 publications

References 91 publications

Prevalence and Outcomes of Depression, Obstructive Sleep Apnea, and Concurrent Anxiety (DOCA) in Stroke Survivors: Insights From a Nationwide Study

Prevalence and Outcomes of Depression, Obstructive Sleep Apnea, and Concurrent Anxiety (DOCA) in Stroke Survivors: Insights From a Nationwide Study

Letter to the Editor of Journal of Otolaryngology regarding “Risk of diabetes in patients with sleep apnea: Comparison of surgery versus CPAP in a long-term follow-up study”

The many faces of obstructive sleep apnea

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