Prevalence of depression in patients referred with snoring and obstructive sleep apnoea

Douglas, Neil J.; Young, Alan; Roebuck, Teanau; Ho, Sally; Miller, Bruce W.; Kee, Kirk; Dabscheck, Eli; Naughton, Matthew T.

doi:10.1111/imj.12108

Cited by 45 publications

(33 citation statements)

References 23 publications

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“…In that study, the prevalence of depression assessed with the MINI questions was 45% and a significant correlation was reported (0.736; p < 0.001) between HADS and the MINI depression questions. 32 This is a much higher prevalence of depression than reported in our study but the fact that Douglas et al 32 only used two screening questions from the MINI has to be considered a limitation and could partially explain the difference in the results. Another recent study indicated that HADS would be an accurate screening tool for assessing major depression among patients in sleep disorder clinics 33 but further studies comparing the use of self-report questionnaires and structured clinical interviews in large cohorts of patients with OSA are needed.…”

Section: Table 4-predictivecontrasting

confidence: 53%

“…An Australian study by Douglas et al 32 showed that among patients with suspected OSA, the overall rate of depression based on doctor diagnosis, Hospital Anxiety and Depression Scale (HADS), or two screening questions from the MINI was 53%. In that study, the prevalence of depression assessed with the MINI questions was 45% and a significant correlation was reported (0.736; p < 0.001) between HADS and the MINI depression questions.…”

Section: Table 4-predictivementioning

confidence: 99%

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The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

Björnsdóttir

Benediktsdóttir

Pack

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: The aims of this study were: (1) to use a standardized psychiatric interview, conducted by a trained psychologist to assess the prevalence of depression among patients with untreated OSA, and (2) to identify if OSA severity or other comorbid disorders (insomnia, hypertension, and diabetes) are related to depression among patients with untreated OSA. Methods: Participants were newly diagnosed patients with OSA (n = 284) waiting to start positive airway pressure (PAP) treatment. The Mini International Neuropsychiatric Interview (MINI) was used to assess depression. Results: Overall, 15.5% of the sample met the diagnosis for dysthymia. Women had a significantly higher prevalence (29.5% versus 11.7% among men, p < 0.001). The prevalence of major depression was 6% in the overall sample and there was no difference in the prevalence among sexes (5.8% among men versus 6.6 % among women). Obesity, daytime sleepiness, low physical activity, initial and late insomnia, low quality of life, and sleep medication and antidepressant use were all related to depression, whereas OSA severity, as measured by apnea-hypopnea index or oxygen desaturation index, was not. Daytime sleepiness, initial insomnia, and sleep medication use were the strongest predictors of depression in multivariable analyses. Conclusions: Sleep medication use, daytime sleepiness, and symptoms of initial insomnia were independently related to depression but OSA severity was not. Increased awareness of the relationship between depression and OSA and the appropriate use of assessment tools might substantially improve diagnostic accuracy as well as treatment outcome for both disorders.

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Section: Table 4-predictivecontrasting

confidence: 53%

Section: Table 4-predictivementioning

confidence: 99%

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

Björnsdóttir

Benediktsdóttir

Pack

et al. 2016

Journal of Clinical Sleep Medicine

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“…5,7 This study provides further evidence for this association, suggesting substantial potential for diagnostic confusion between the entities. It improves on previous studies by: investigating a relatively large number of participants; characterizing OSA presence and severity using gold standard laboratory polysomnography; assessing depressive symptoms prospectively using a well validated screening tool; accounting for potential age and obesity confounding; assessing the influence of gender on this relationship; and by determining the efficacy of CPAP treatment on depressive symptomatology using an objective method (device recorded hours of use) to assess compliance.…”

Section: Depressive Symptoms Are Common Among People With Osamentioning

confidence: 58%

“…3,5,6 Many previous studies have been of low power or have used a variety of instruments of varying quality to assess depressive symptoms. 6 Lack of direct contact with patients and retrospective assessment of depressive symptoms rather than assessment prior to diagnosis of OSA have been limitations of some of them.…”

Section: S C I E N T I F I C I N V E S T I G At I O N Smentioning

confidence: 99%

Depressive Symptoms before and after Treatment of Obstructive Sleep Apnea in Men and Women

Edwards

Mukherjee

Simpson

et al. 2015

Journal of Clinical Sleep Medicine

111

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Study Objectives: To determine prevalence of depressive symptoms in obstructive sleep apnea (OSA) and the impact of OSA treatment on depression scores. Methods: Consecutive new patients referred for investigation of suspected OSA were approached. Consenting patients completed a patient health questionnaire (PHQ-9) for depressive symptoms when attending for laboratory polysomnography. Those with moderate/severe (apneahypopnea index [AHI] ≥ 15 events/h) and/or symptomatic mild OSA (AHI 5-14.99 events/h) were offered continuous positive airway pressure (CPAP) therapy. PHQ-9 was repeated after 3 months of CPAP with compliance recorded. Of a maximum PHQ-9 score of 27, a cut point ≥ 10 (PHQ-9 ≥ 10) was used to indicate presence of clinically signifi cant depressive symptoms. Results: A total of 426 participants (243 males) were recruited. Mean ± standard deviation body mass index (BMI) was 32.1 ± 7.1 kg/m 2 and AHI 33.6 ± 28.9 events/h. PHQ-9 was 10.5 ± 6.1 and independently related to AHI (p < 0.001) and BMI (p < 0.001). In those without OSA, PHQ-9 ≥ 10 was more common in women, but no gender difference was evident with OSA. Of 293 patients offered CPAP, 228 were compliant (mean nightly use > 5 h) over 3 months of therapy. In them, with therapy, AHI decreased from 46.7 ± 27.4 to 6.5 ± 1.6 events/h, PHQ-9 from 11.3 ± 6.1 to 3.7 ± 2.9 and PHQ-9 ≥ 10 from 74.6% to 3.9% (p < 0.001 in each case). Magnitude of change in PHQ-9 was similar in men and women. Antidepressant use was constant throughout. Conclusions: Depressive symptoms are common in OSA and related to its severity. They improve markedly with CPAP, implying a relationship to untreated OSA. Keywords: patient health questionnaire, depression, depressive symptoms, obstructive sleep apnea, continuous positive airway pressure. Citation: Edwards C, Mukherjee S, Simpson L, Palmer LJ, Almeida OP, Hillman DR. Depressive symptoms before and after treatment of obstructive sleep apnea in men and women. J Clin Sleep Med 2015;11(9):1029-1038.pii: jc-00354-14 http://dx.doi.org/10.5664/jcsm.5020 P ersistent sleep loss causes symptoms that are similar to those of depression, in part because frontal lobe centers responsible for emotional modulation are sensitive to disturbed sleep.1 Consistent with this observation, obstructive sleep apnea (OSA), a condition characterized by fragmented sleep, is commonly associated with depressive symptoms.2 Conversely, depression is often associated with disturbed sleep. Further, depression and OSA are prevalent in the community and, hence, could be expected to coexist in a signifi cant proportion of patients. The multidirectional relationships between depression, disturbed sleep, and OSA are a source of potential diagnostic confusion, which may explain why OSA, a generally under-recognized condition, is particularly under-diagnosed among people with depression.3 Failure to recognize and treat OSA in depressed patients may lead to inappropriate prescription of antidepressant therapy and/or persistence of depressive symptoms despite such therapy....

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“…Patients with depression are often referred to sleep laboratories with complaints of insomnia or, less frequently, with unusually long sleep of low quality (5). Some clinical rating scales for depression focus on fatigue and tiredness rather than EDS, and a potential association between …”

Section: Mood and Sleepinessmentioning

confidence: 99%

Multiple dimensions of excessive daytime sleepiness

Smith¹,

Rossdale²,

Serry³

et al. 2018

J. Thorac. Dis.

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Background: In this study we investigated subjective measures of sleepiness and related our findings to dimensions of affect, fatigue, emotion, mood and quality of life based on a hypothetical multidimensional model of sleepiness. Methods: Patients referred to a sleep clinic were assessed regarding their excessive daytime sleepiness (EDS), sleep complaints, routine and symptoms. Age, gender and body mass index (BMI), the Epworth Sleepiness Scale (ESS), the Stanford Sleepiness Scale (SSS), the Samn-Perelli fatigue Scale (SPS), the Global Vigor and Affect Scale (GVS and GAS, respectively), the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and the Positive and Negative Affect Schedule (PAS and NAS, respectively) scores Conclusions: A model of sleepiness that assesses dimensions of fatigue and anxiety could explain the symptom of subjective sleepiness better than the isolated use of the ESS.

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Prevalence of depression in patients referred with snoring and obstructive sleep apnoea

Cited by 45 publications

References 23 publications

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

Depressive Symptoms before and after Treatment of Obstructive Sleep Apnea in Men and Women

Multiple dimensions of excessive daytime sleepiness

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