OSA, excessive daytime sleepiness associated with depression in men

DENVER — Men with previously undiagnosed obstructive sleep apnea and excessive daytime sleepiness were more than four times more likely to have increased risk for depression than men without either condition, according to study results presented at the American Thoracic Society International Conference.

“An association between sleep apnea and depression has been noted in previous clinical research but now we know just how strong this relationship really is in the general community,” Carol J. Lang, PhD, of the University of Adelaide in Australia, told Healio.com/Pulmonology. “Our study found excessive daytime sleepiness and severe obstructive sleep apnea are both associated with the prevalence and onset of depression, and the presence of both is associated with an even greater risk.”

Carol J. Lang

Lang and colleagues used Beck’s Depression Inventory (BDI) and the Center for Epidemiological Studies Depression Scale (CES-D) to assess 1,875 men aged 35 to 83 years at two time points to determine if excessive daytime sleepiness (EDS) and previously diagnosed and undiagnosed obstructive sleep apnea (OSA) were associated with prevalence and incidence of depression.

A random sample of 857 men without previously diagnosed OSA underwent polysomnography at home and completed the Epworth Sleepiness Scale questionnaire. Data indicated previously undiagnosed, severe OSA was associated with an increased prevalence of depression (adjusted OR = 2.1; 95% CI, 1.1-4), as was EDS (aOR = 1.1; 95% CI, 1-1.2).

According to study data, men with previously undiagnosed EDS and OSA had a 4.2-fold greater risk for depression than men without EDS and OSA. Men with undiagnosed EDS and OSA were 3.5 times more likely to have depression than those with either EDS or OSA.

Previously undiagnosed OSA (OR = 2; 95% CI, 1.15-3.45) and undiagnosed severe OSA (aOR = 2.9; 95% CI, 1.19-6.92), determined by an apnea hypopnea index score of at least 30, also had an increased risk for depression at follow-up over a 5-year period.

“For people with sleep apnea or their families, our advice is to simply be aware of the increased risk for depression and talk to your general practitioner if you have any concerns,” Lang said. “Some OSA patients find it hard to keep complying with their CPAP or other treatment plans for OSA, but our advice is to persist if you can because the benefits for your long-term physical and mental health may be significant.”

Lang also said patients with depressive disorders should raise any sleep concerns with their physicians. Often, these problems are not investigated because it is assumed they are a result of the depression.

“Given that as many as one in three people in the U.S. suffers from OSA and most of these are undiagnosed, it is certainly worth asking the question,” Lang said. – by Ryan McDonald

Reference:

Lang CJ, et al. Abstract 62529. Presented at: American Thoracic Society International Conference; May 15-20, 2015; Denver.

Disclosure: Lang reports no relevant financial disclosures.