Obstructive sleep apnea and depression

Abstract

Phone +61 2 9515 8630 Fax +61 2 9515 7070 For correspondence Dr Harris can now be contacted at melanie.harris@unisa.edu.au.Please cite this as: . Obstructive sleep apnea and depression. Sleep Medicine Reviews, 13(6), 437-444. doi:10.1016437-444. doi:10. /j.smrv.2009437-444. doi:10. .04.001 Copyright 2009 Elsevier.Archived at Flinders University: dspace.flinders.edu.au AbstractThere are high rates of depression in people with obstructive sleep apnea (OSA) in both community and clinical populations. A large community study reported a rate of 17% and reports for sleep clinic samples range between 21% and 41%. A large cohort study found OSA to be a risk factor for depression, but we are unaware of any longitudinal study of the reverse association. However correlations have not generally been found in smaller studies. Well-designed longitudinal studies are needed to examine temporal relationships between the two conditions and further research is needed to establish the role of confounders, and effect modifiers such as gender, in any apparent relationship. Symptoms common to OSA and depression, such as sleepiness and fatigue, are obstacles to determining the presence and severity of one condition in the presence of the other, in research and clinically. Sleep clinicians are advised to consider depression as a likely cause of sleepiness and fatigue. Several possible causal mechanisms linking OSA and depression have been proposed but not established. Patients who have depression as well as OSA appear worse off than those with OSA only, and depressive symptoms persist in at least some patients in short term studies of treatment for OSA. Direct treatment of depression in OSA might improve acceptance of therapy, reduce sleepiness and fatigue and improve quality of life, but intervention trials are required to answer this question.

The contribution of fatigue and sleepiness to depression in patients attending the sleep laboratory for evaluation of obstructive sleep apnea

“…Another possible confounder affecting the relationship between OSA and depression, which may also interact with gender, is obesity [3,5]. Indeed a significant association between BMI and depression scores emerged in the current study, however this did not influence the relationship between fatigue and depression in a separate analysis.…”

“…Patients with a greater severity of OSA may have greater functional impairment and report higher daytime sleepiness than the patients used in the current study. Significant differences between primary snorers and control subjects on depression and mood scores were observed, but given the small group sizes, and the inherent referral bias of recruiting at sleep clinics [5], this finding should be interpreted with caution.…”

“…Depressive symptoms are commonly reported by patients with Obstructive Sleep Apnea (OSA), and higher rates of depressive symptomatology in OSA patients have been observed in a number of prevalence studies when compared to the general population [1][2][3][4][5]. Between 15% and 56% of OSA patients are diagnosed with a depressive disorder [2,[6][7][8] compared to only 6.6% of the general population [9].…”

Sleep apnea classification based on respiration signals by using ensemble methods

“…Sleep apnea defined as the disruption of breathing for more than 10 s in adults [2]. Daytime sleepiness, impaired concentration, depression, memory loss, tiredness and early morning headaches can be observed in SAS patients [3][4][5][6]. Besides, untreated and undiagnosed sleep apnea can relate to heart disease like hypertension, myocardial infarction and stroke [7][8][9].Sleep disorders have become important factors that adversely affect individuals' quality of life and society as a whole [10].…”

Excessive sleepiness and the risk of obstructive apnoea syndrome in professional ambulance drivers

“…U osnovi zdravstvenih efekata OSA se nalaze hronična intermitentna hipoksija (hipoksemija) i fragmentacija sna [35]. OSA je često prisutna kod osoba sa kardiovaskularnim, metaboličkim i psihičkim poremećajima i predstavlja nezavisni faktor rizika za nastanak ovih bolesti [36][37][38]. Prisustvo nelečene teške OSA je povezano sa porastom ukupnog i mortaliteta od koronarnih događaja [39,40].…”