CPAP Therapy on Depressive and Anxiety Symptoms in Patients with Moderate to Severe Obstructive Sleep Apnea Syndrome

Abstract

Backgrounds and Objectives: There is a link between sleep apnea syndrome (OSA) and depressive and anxiety symptoms, but the underlying mechanisms are not fully understood. The study aimed to determine the prevalence of these symptoms in patients with OSA and to evaluate the impact of continuous positive airway pressure (CPAP) on depression and anxiety scores. Materials and Methods: Ninety-nine consecutive new patients diagnosed with moderate or severe (apnea-hypopnea index AHI ≥ 15 events/h) OSA were accepted for the CPAP therapy. Patients completed a patient health questionnaire (PHQ-9) for depressive symptoms and a generalized anxiety questionnaire (GAD-7) for anxiety symptoms before the CPAP treatment, after 6 months, and after 1 year of CPAP therapy with compliance. For both scores (PHQ-9 and GAD-7), a cut point ≥10 was used to indicate the presence of clinically depressive and anxiety symptoms. Results: Forty-eight individuals (48.48%) had PHQ-9 scores above the cut-off point ≥ 10, and twenty-seven participants (27.27%) had GAD-7 scores above the cut-off point ≥10. A significant correlation has been shown between PHQ-9 score and BMI (p < 0.0001), AHI (p < 0.0001), ODI (p < 0.001), ESS (p < 0.001), GAD-7 score (p < 0.0001), and [t90] (p < 0.0001), while GAD-7 was correlated with AHI (p < 0.030), ODI (p < 0.006), and [t90] (p < 0.001). The PHQ-9 and GAD-7 scores decreased significantly after 6 months of CPAP therapy in all groups and after 1 year of CPAP use. Conclusions: OSA patients should be screened for depression and anxiety. Furthermore, CPAP should be the first choice of treatment before starting other treatments for depression and anxiety symptoms.

Approach the Patient With Obstructive Sleep Apnea and Obesity

“…OSA is more likely in men aged 18 to 64 years with anxiety and hypertension than those with only hypertension ( 128 ). Anxiety decreased after 6 months of CPAP treatment in 1 small study ( 129 ).…”

Association of Sleep Characteristics with Tinnitus and Hearing Loss

“…In contrast, a prior non‐randomized, noncontrolled study assessing the impact of CPAP treatment on tinnitus found that the Tinnitus Handicap Inventory scores significantly decreased with CPAP use after 3 months for 14 patients with sleep‐disorder breathing and tinnitus symptoms 55 . Multiple studies have shown improvements in depression and anxiety symptoms following CPAP use, which have been heavily linked to tinnitus 56,57 . CPAP treatment for OSA may have positive impact on mitigating bothersome tinnitus.…”

“… 55 Multiple studies have shown improvements in depression and anxiety symptoms following CPAP use, which have been heavily linked to tinnitus. 56 , 57 CPAP treatment for OSA may have positive impact on mitigating bothersome tinnitus. Whether this is due to CPAP's improvement of tinnitus or the noise‐masking of a CPAP machine, a known treatment for tinnitus, is unknown.…”

Bi-level VNS therapy with different therapy modes at night and daytime improves seizures and quality of life in a patient with drug-resistant epilepsy

“…In numerous retrospective and prospective evaluations, OSA has been shown to be correlated with cognitive impairment, dementia and depression [10] , [11] , [12] , [13] , [14] , [15] , [16] . Treating OSA with CPAP therapy has been shown to lead to improvement of executive function [17] and depressive symptoms [18] , [19] . These effects are so strong, that CPAP has been proposed as first line therapy in patients with OSA and depression, before starting a pharmacological treatment [18] .…”

“…Treating OSA with CPAP therapy has been shown to lead to improvement of executive function [17] and depressive symptoms [18] , [19] . These effects are so strong, that CPAP has been proposed as first line therapy in patients with OSA and depression, before starting a pharmacological treatment [18] .…”