Evaluation of the risk factors of depressive disorders comorbid with obstructive sleep apnea

Abstract

ObjectiveOverlap of obstructive sleep apnea (OSA) complicates diagnosis of depressive disorder and renders antidepressant treatment challenging. Previous studies have reported that the incidence of OSA is higher in patients with depression than in the general population. The purpose of this article was to investigate clinical risk factors to predict OSA in depression disorders.MethodsA total of 115 patients diagnosed with major depressive disorder (MDD) and bipolar disorder (in a major depressive episode), who underwent overnight polysomnography, were studied retrospectively. They were divided into two groups: non-OSA and OSA. The patients who had apnea–hypopnea index (AHI) <5 were defined as the non-OSA group, whereas the OSA group was defined as those with an AHI ≥5. Logistic regression was used to analyze the association among AHI and clinical factors, including sex, age, body mass index (BMI), Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale, Pittsburgh Sleep Quality Index (PSQI), and diagnosis (MDD or bipolar disorder [in a major depressive episode]).ResultsIn 115 patients, 51.3% had OSA. Logistic regression analysis showed significant associations between AHI and diagnosis (MDD or bipolar disorder [in a major depressive episode]), BMI, HAMD, and PSQI (P<0.05).ConclusionThe findings of our study suggested that the rate of depression being comorbid with OSA is remarkably high and revealed that there is a high rate of undetected OSA among depressive disorder patients and untreated OSA among mood disorder patients. The clinical risk factors (diagnosis [MDD or bipolar disorder {in a major depressive episode}], BMI, HAMD, and PSQI) could predict AHI or OSA diagnosis and contribute to OSA screening in depressive disorder patients.

Effects of continuous positive airway pressure on neurocognitive and neuropsychiatric function in obstructive sleep apnea

“…On the other hand, cognitive impairment may be a consequence of EDS due to sleep fragmentation (Zhou et al, 2016). In the context of mood disorders with OSA, a higher degree of depressive and anxiety symptoms is frequently described (Acker et al, 2017;Cai, Xu, Wei, Sun, & Chen, 2017;Ejaz, Khawaja, Bhatia, & Hurwitz, 2011;Schroder & ÓHara, 2005). Depression in particular is closely linked with OSA due to common clinical symptoms (Acker et al, 2017;BaHammam et al, 2016;Ejaz et al, 2011;Fidan, Unlu, Sezer, Gecici, & Kara, 2007;Naqvi et al, 2014).…”

“…When the effect of CPAP is detected, improvement depends on the duration of CPAP use, both in the context of an average number of hours per night and the number of months since the start of CPAP treatment (Antic et al, 2011;Ferini-Strambi et al, 2003;Sforza & Roche, 2012). Most studies on the subject have reported a significant association between CPAP treatment and decreased depressive and anxiety symptoms (Cai et al, 2017;Celik et al, 2016). Longitudinally, CPAP treatment improves mood disorders and vigilance, which is associated with a lower frequency of traffic accidents (Jackson et al, 2011;Yamamoto, Akashiba, Kosaka, Ito, & Horie, 2000).…”

Evaluation of depression comorbidity in obstructive sleep apnea syndrome

“…The first these argued that OSAS patients experienced a high level of depression, while the latter claimed that the depression comorbidity was coincidental and not significant. The third stated that OSAS was not associated with depression [32]. There are even studies which reported that there was a negative correlation between total depression scores and OSAS [33,34].…”

Depression, obstructive sleep apnea and psychosocial health

“…Patients who do not improve after taking antidepressant therapy and have symptoms of OSA should be screened for OSA and be treated with CPAP if OSA is diagnosed. [19][20][21] Patients who were diagnosed with MDD and treated by antidepressants but saw no improvement started to see their depression symptoms resolved when they began taking CPAP therapy. 12 Mood disorder and depressive symptoms associated with OSA can be improved by CPAP therapy, but the effect of treatment can take longer depending on the variations and severity of the mood symptoms.…”