For Individuals with Obstructive Sleep Apnea, Institution of CPAP therapy is Associated with an Amelioration of Symptoms of Depression which is Sustained Long Term

Schwartz, Daniel P.; Karatinos, Gillian

doi:10.5664/jcsm.26975

Cited by 58 publications

(13 citation statements)

References 23 publications

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“…According to the published data, depression seems to correlate more with excessive daytime sleepiness than hypoxemia [15,16]. Moreover, CPAP treatment resulted in improvement of depression scores [17]. On the other hand, from the physiological point of view, hypoxia induced neuronal dysfunction, vascular abnormalities caused by an increase in nocturnal blood pressure and sympathetic activation or hormonal derangements such as lower androgen levels are possible causes of ED in men with OSAHS [18–21].…”

Section: Discussionmentioning

confidence: 99%

Is Sexual Dysfunction in Women with Obstructive Sleep Apnea-Hypopnea Syndrome Associated with the Severity of the Disease? A Pilot Study

Önem

Erol

Şanlı

et al. 2008

The Journal of Sexual Medicine

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Introduction Obstructive sleep apnea-hypopnea syndrome (OSAHS) may have a significant negative effect on sexual function. Aim To evaluate female sexual function in women with OSAHS. Methods Twenty-six patients with OSAHS were evaluated in two groups according to apnea-hypopnea index as mild (5–15, Group I, N = 16) or moderate-severe (≥15, Group II, N = 10). A third group (N = 10) of patients suspected of sleeping disorders other than OSAHS who also underwent polysomnographic studies served as the control group. All women were evaluated with a detailed sexual history including Female Sexual Function Index (FSFI) questionnaire and Beck Depression Inventory (BDI). Meanwhile, serum levels of estradiol, prolactin, total and free testosterone and dihydroepiandrostenedione-S were determined. Main Outcome Measures FSFI, BDI, and serum hormonal levels. Results The mean ages and total FSFI scores of Group I, Group II and the control group were 46 ± 7.1, 45 ± 3.8, and 41 ± 5.4 (P > 0.05); 24.7 ± 5.3, 24.5 ± 6.3, and 30.0 ± 2.5 (P < 0.05), respectively. The mean FSFI domain scores were not statistically different between Groups I and II (P > 0.05) (desire, 3.18 ± 1.2 vs. 2.92 ± 1.6; arousal, 3.96 ± 1.1 vs. 3.67 ± 1.2; lubrication, 4.83 ± 1.0 vs. 4.12 ± 1.1; orgasm 4.0 ± 1.1 vs. 5.15 ± 2.9; satisfaction 3.96 ± 1.1 vs. 4.05 ± 1.4 pain; 4.84 ± 1.2 vs. 4.65 ± 1.3). However, the mean scores of desire (3.18 ± 1.2 vs. 3.96 ± 0.7), orgasm (4.0 ± 1.1 vs. 5.0 ± 1.1), and satisfaction (3.96 ± 1.1 vs. 4.76 ± 1.0) domains of Group I were significantly lower than the control group. Meanwhile, the mean scores of desire (2.92 ± 1.6 vs. 3.96 ± 0.7) and lubrication (4.12 ± 1.1 vs. 5.22 ± 0.9) domains were statistically different between Group II and the control group. The mean BDI scores of patients in Group I, Group II and the control group were 19.3 ± 6.3, 20.2 ± 6.6, and 11.0 ± 7.1, respectively (P < 0.01). In addition, the mean levels of hormonal parameters were not significantly different from the control group (P > 0.05). Conclusions OSAHS is associated with a significant decrease in female sexual function. However, severity of OSAHS is not related with the degree of female sexual dysfunction (FSD). This situation reveals that both organic and psychogenic issues are being involved in FSD related with OSAHS.

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Section: Discussionmentioning

confidence: 99%

Is Sexual Dysfunction in Women with Obstructive Sleep Apnea-Hypopnea Syndrome Associated with the Severity of the Disease? A Pilot Study

Önem

Erol

Şanlı

et al. 2008

The Journal of Sexual Medicine

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“…In support of this hypothesis, 17 OSA patients with treatment resistant depression reported a significant reduction in Hamilton Depression Rating Scale scores after two months of CPAP therapy, however, antidepressant use at follow-up was not reported (Habukawa et al, 2010). Two further studies have tracked rates of antidepressant use before and after CPAP treatment (Gagnadoux et al, 2014;Schwartz & Karatinos, 2007). In a large observational study of 300 OSA patients, 89 participants were using antidepressants at baseline, and 46% had discontinued their medication after at least one year of CPAP use (Gagnadoux et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Nightly hours of CPAP use was not associated with change in depression status, contrary to expectations. Few previous studies have examined associations between depression and objectively monitored treatment usage (Gagnadoux et al, 2014;Habukawa et al, 2010;Relia et al, 2018), with some relying on patients' selfreported usage (Schwartz & Karatinos, 2007). In a recent large clinical cohort study, patients who were deemed "adherent" ( > 4 h use per night, for at least 70% of nights per week) showed a clinically significant improvement in Patient Health Questionnaire (PHQ-9) depressive symptoms (Relia et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Does continuous positive airways pressure treatment improve clinical depression in obstructive sleep apnea? A randomized wait‐list controlled study

Jackson

Tolson

Schembri

et al. 2020

Depression and Anxiety

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Background: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder that is associated with a range of adverse daytime sequelae, including significantly higher rates of clinical depression than is seen in the general community. Improvements in depressive symptoms occur after treatment of the primary sleep disorder, suggesting that comorbid depression might be an intrinsic feature of OSA. However, there are limited data on whether treatment for OSA in patients diagnosed with clinical depression improves mood symptoms meaningfully enough to lead to the remission of the psychiatric diagnosis.Methods: N = 121 untreated OSA patients were randomized to either continuous positive airway pressure (CPAP) treatment or waitlist control, and depressive symptoms, sleepiness and clinical depression (using a structured clinical interview) were assessed at baseline and 4 months. Linear and logistic regression analyses were conducted, controlling for baseline scores, stratification factors and antidepressant use. Results: Depressive symptoms (odds ratio [OR] = −4.19; 95% confidence interval [CI] =−7.25, −1.13; p = .008) and sleepiness (OR = −4.71; 95% CI = −6.26, −3.17; p < .001) were significantly lower at 4 months in the CPAP group compared to waitlist. At 4 months, there was a significant reduction in the proportion of participants in the CPAP group meeting criteria for clinical depression, compared to the waitlist controls (OR = 0.06, 95% CI = 0.01, 0.37; p = .002). Conclusion:Treatment of OSA may be a novel approach for the management and treatment of clinical depression in those with comorbid sleep disordered breathing.Larger trials of individuals with clinical depression and comorbid OSA are needed.

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“…Some studies have suggested that obese individuals (in cultures where obesity is stigmatized) may experience weight-related stigma and discrimination, [18] and that they often suffer from obstructive sleep apnea. [19] Obese individuals have also been reported to have disturbed neuroendocrine function and increased levels of circulating inflammatory cytokines. [20,21] Again, obese subjects lead sedentary lives, [22] which worsens the obesity.…”

Section: Discussionmentioning

confidence: 99%

Association between anxiety and obesity: A study of a young.adult Nigerian population

Ejike

2013

Journal of Neurosciences in Rural Practice

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Background:The relationship between anxiety and obesity is still debatable and seems to vary between cultures. The subject has been scarcely investigated in Nigeria, hence this study.Materials and Methods:A total of 1584 young-adult Nigerians (56.4% males) of mean age 21.8 ± 2.2 years were studied. Anxiety was assessed using the Beck's Anxiety Index (BAI), while obesity was determined using the bioelectrical impedance analysis (BIA) and body mass index (BMI) methods. Standard protocols were followed for all assessments and measurements. Appropriate descriptive statistics were carried out, while regression and correlation analyses (for continuous variables) and the Chi square tests (for categorical variables) were used to assess the relationship between anxiety and obesity.Results:The degree of adiposity of the subjects (males and females alike) classified by %BF standards did not significantly (P > 0.05) affect the proportion of the population with any degree of anxiety. The proportion of population with high anxiety (for both sexes) was similar (P > 0.05) irrespective of their BMI status. All the obese (BMI-wise only) males had low anxiety, while the proportion of thin females (in the low anxiety group) was significantly (P < 0.05) higher than that of their normal weight counterparts. There was neither a significant correlation nor a significant association (P > 0.05) between the BAI scores and the studied measures of adiposity in both male and female subjects.Conclusion:The low prevalence of both anxiety and obesity in the studied population may explain the observed lack of association between the studied variables. These findings do not support the “jolly fat” hypothesis.

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For Individuals with Obstructive Sleep Apnea, Institution of CPAP therapy is Associated with an Amelioration of Symptoms of Depression which is Sustained Long Term

Cited by 58 publications

References 23 publications

Is Sexual Dysfunction in Women with Obstructive Sleep Apnea-Hypopnea Syndrome Associated with the Severity of the Disease? A Pilot Study

Is Sexual Dysfunction in Women with Obstructive Sleep Apnea-Hypopnea Syndrome Associated with the Severity of the Disease? A Pilot Study

Does continuous positive airways pressure treatment improve clinical depression in obstructive sleep apnea? A randomized wait‐list controlled study

Association between anxiety and obesity: A study of a young.adult Nigerian population

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