When a patient with depression is feeling sleepy, be aware of sleep apnoea

Abstract

A 67-year-old man was referred to an outpatient clinic of geriatric psychiatry because of persistent symptoms of depression and anxiety, accompanied by sleepiness. The latter had been evaluated multiple times in the general practice over several years; each time it was considered to be a symptom of depression. After referral, the patient was diagnosed with severe obstructive sleep apnoea (OSA), comorbid to a depressive and anxiety disorder. Retrospectively, we conclude that affective symptoms accompanying OSA and sleepiness were wrongfully interpreted as depression, but after having led to problems at work, they have triggered psychiatric comorbidity. Treatment of OSA in addition to the psychiatric disorders resulted in a full recovery over time. The delayed diagnosis of OSA has certainly diminished the patient’s quality of life and might have precipitated the depressive disorder. Moreover, OSA poses patients at an increased risk of cardiovascular disease, hypertension, stroke and traffic accidents.

A Clinicl Case Report on Black Dog (Depression)

“…It is also possible to correlate physical depression with physical symptoms. Fatigue or low energy, disturbed sleeping, particularly waking early in the morning, especially headaches, treatment Feeling or appearing to be slowed or irritated [9]. Treatment of this antidepressant, antipsychotic drug, antihypertensive, anticonvulsant antipsychotics, benzodiazepine and antianxiety along with this psychotherapy is most important such as speaking therapy, Light therapy, alternative therapies, exercise, medication, yoga [10].…”

Self-reported health outcomes in patients with obstructive sleep apnoea: Unraveling the role of bio-psycho-social factors

“…a previous study reported a higher anxiety dream incidence in OSA patients (Carrasco et al, 2006) and OSA-related snoring when compared to controls (de Groen et al, 1993). OSA also appears to confer a higher risk for future development of nocturnal panic attacks due to breathing-related OSA symptoms (Edlund et al, 1991;, as well as somatic symptoms of anxiety such as excessive sweating, or nightmares (Wiersema et al, 2018). In light of these findings, it can be assumed that anxiety as measured in our study may be associated with psychophysiological symptomatology related to panic attacks, rather than with anxiety in general.…”

“…Neuroimaging techniques also showed that loneliness may consequently lead to an increased level of hypervigilance to hostile cues and a negative attitude towards others (Cacioppo et al, 2016). Moreover, higher levels of anxiety or hostility identified in OSA patients Wiersema et al, 2018) may be associated with a lack of ability to communicate with others (Perfect et al, 2013), social inhibition, social dysfunction , and oppositional orientation towards others . Thus, it may be assumed that patients with OSA, identified as hostility-prone, may have even poorer motivation to participate in social activities.…”