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J Clin Sleep Med. 2015 Sep 15;11(9):1029-38. doi: 10.5664/jcsm.5020.

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

Author information

1
School of Surgery, University of Western Australia, Crawley, Australia.
2
West Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Nedlands, Australia.
3
Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
4
Centre for Genetic Origins of Health and Disease, University of Western Australia, Crawley, Australia.
5
Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, Australia.
6
The Joanna Briggs Institute and School of Translational Health Science, University of Adelaide, Adelaide, Australia.
7
WA Centre for Health & Ageing and School of Psychiatry & Clinical Neurosciences, University of Western Australia, Crawley, Australia; Department of Psychiatry, Royal Perth Hospital, Perth, Australia.

Abstract

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 significant 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/m2 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:

continuous positive airway pressure; depression; depressive symptoms; obstructive sleep apnea; patient health questionnaire

PMID:
25902824
PMCID:
PMC4543247
DOI:
10.5664/jcsm.5020
[Indexed for MEDLINE]
Free PMC Article

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