Obstructive sleep apnea and depression: a review - PubMed (original) (raw)

Obstructive sleep apnea and depression: a review

Shakir M Ejaz et al. Innov Clin Neurosci. 2011 Aug.

Abstract

Obstructive sleep apnea is a common sleep disorder associated with several medical conditions, increased risk of motor vehicle accidents, and overall healthcare expenditure. There is higher prevalence of depression in people with obstructive sleep apnea in both clinical and community samples. Many symptoms of depression and obstructive sleep apnea overlap causing under-diagnosis of obstructive sleep apnea in depressed patients. Sleep problems, including obstructive sleep apnea, are rarely assessed on a regular basis in patients with depressive disorders, but they may be responsible for antidepressant treatment failure. The mechanism of the relationship between obstructive sleep apnea and depression is complex and remains unclear. Though some studies suggest a mutual relationship, the relationship remains unclear. Several possible pathophysiological mechanisms could explain how obstructive sleep apnea can cause or worsen depression. Increased knowledge of the relationship between obstructive sleep apnea and depression might significantly improve diagnostic accuracy as well as treatment outcomes for both obstructive sleep apnea and depression.

Keywords: CPAP; OSA; Obstructive sleep apnea; continuous positive airway pressure; depression; sleep disordered breathing.

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Figures

Figure 1

Figure 1

Overnight pulse oximetry testing. Mean oxygen saturation: 88%; minimum saturation 60%; number of events with desaturation >4%=95. Arrow indicates severity of desaturation in clusters, suggesting sleep-stage-dependent worsening of respiratory function.

Figure 2

Figure 2

Overlapping symptoms of obstructive sleep apnea (OSA) and major depression. Adapted from: American Academy of Sleep Medicine. International Classification of Sleep Disorders, Second Edition, Diagnostic and Coding Manual. Westchester, IL: American Academy of Sleep Medicine; 2005; American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association; 2000; and Kryger, MH, Roth T, Dement WC (eds). Principles and Practice of Sleep Medicine, Fourth Edition. Philadelphia, PA: W.B. Saunders; 2005.

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