Depression score changes in response to sleep disordered breathing treatment with positive airway pressure in a large clinic-based cohort

Relia, Sachin; Thompson, Nicolas R.; Mehra, Reena; Moul, Douglas E.; Katzan, Irene; Foldvary‐Schaefer, Nancy; Walia, Harneet K.

doi:10.1007/s11325-018-1626-6

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…Edwards et al (2015) also demonstrated that improving sleep quality led to a significant reduction in the number of people with sleep apnea meeting the clinical cutoff for depression as measured by the PHQ-9, with this proportion reducing from 74.6% to just 3.9% following intervention. Similar results have been demonstrated by others (Balcan et al 2019;Relia et al 2018). Since eveningness is associated with reduced sleep quality and duration, we propose that insomnia symptoms can partially explain the prevalence of poorer affective outcomes in E-types, rather than eveningness having an intrinsic detrimental effect on well-being.…”

supporting

confidence: 90%

Insomnia symptoms mediate the association between eveningness and suicidal ideation, defeat, entrapment, and psychological distress in students

Bradford

Biello

Russell

2021

Chronobiology International

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Chronotype describes a person's general preference for mornings, evenings, or neither. It is typically conceptualized as a continuous unidimensional spectrum from morningness to eveningness. Eveningness is associated with poorer outcomes across a myriad of physical and mental health outcomes. This preference for later sleep and wake times is associated with increased risk of depression, anxiety, and suicidal ideation in both clinical and community samples. However, the mechanisms underlying the negative consequences of this preference for evenings are not fully understood. Previous research has found that sleep disturbances may act as a mediator of this relationship. The present study aimed to explore the associations between chronotype and affective outcomes in a sample of students. Additionally, it aimed to investigate the potential role of insomnia as a mediator within these relationships. Participants (n = 190) completed an anonymous self-report survey of validated measures online which assessed chronotype, insomnia symptoms, and a range of affective outcomes (defeat, entrapment, suicide risk, stress, and depressive and anxious symptomology). Eveningness was associated with more severe or frequent experiences of these outcomes, with participants that demonstrated a preference for eveningness more likely to report poorer affective functioning and increased psychological distress. Mediation analysis found the relationship between chronotype and these outcome measures was completely or partially mediated by insomnia symptom severity measured by the validated Sleep Condition Indicator insomnia scale. Taken together, these findings add further evidence for the negative consequences of increased eveningness. Additionally, our results show that chronotype and sleep disturbances should be considered when assessing mental well-being. Implementing appropriate sleep-related behavior change or schedule alterations can offer a tool for mitigation or prevention of psychological distress in students that report a preference for later sleep and wake times.

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supporting

confidence: 90%

Insomnia symptoms mediate the association between eveningness and suicidal ideation, defeat, entrapment, and psychological distress in students

Bradford

Biello

Russell

2021

Chronobiology International

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“…Few previous studies have examined associations between depression and objectively monitored treatment usage (Gagnadoux et al, 2014;Habukawa et al, 2010;Relia et al, 2018), with some relying on patients' selfreported usage (Schwartz & Karatinos, 2007). In a recent large clinical cohort study, patients who were deemed "adherent" ( > 4 h use per night, for at least 70% of nights per week) showed a clinically significant improvement in Patient Health Questionnaire (PHQ-9) depressive symptoms (Relia et al, 2018). In contrast, Habukawa et al (2010) did not find any difference in CPAP hours of use between depression responders and non-responders.…”

Section: Discussionmentioning

confidence: 99%

Does continuous positive airways pressure treatment improve clinical depression in obstructive sleep apnea? A randomized wait‐list controlled study

Jackson

Tolson

Schembri

et al. 2020

Depression and Anxiety

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Background: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder that is associated with a range of adverse daytime sequelae, including significantly higher rates of clinical depression than is seen in the general community. Improvements in depressive symptoms occur after treatment of the primary sleep disorder, suggesting that comorbid depression might be an intrinsic feature of OSA. However, there are limited data on whether treatment for OSA in patients diagnosed with clinical depression improves mood symptoms meaningfully enough to lead to the remission of the psychiatric diagnosis.Methods: N = 121 untreated OSA patients were randomized to either continuous positive airway pressure (CPAP) treatment or waitlist control, and depressive symptoms, sleepiness and clinical depression (using a structured clinical interview) were assessed at baseline and 4 months. Linear and logistic regression analyses were conducted, controlling for baseline scores, stratification factors and antidepressant use. Results: Depressive symptoms (odds ratio [OR] = −4.19; 95% confidence interval [CI] =−7.25, −1.13; p = .008) and sleepiness (OR = −4.71; 95% CI = −6.26, −3.17; p < .001) were significantly lower at 4 months in the CPAP group compared to waitlist. At 4 months, there was a significant reduction in the proportion of participants in the CPAP group meeting criteria for clinical depression, compared to the waitlist controls (OR = 0.06, 95% CI = 0.01, 0.37; p = .002). Conclusion:Treatment of OSA may be a novel approach for the management and treatment of clinical depression in those with comorbid sleep disordered breathing.Larger trials of individuals with clinical depression and comorbid OSA are needed.

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“…17 A study of 1,981 patients with sleep-disordered breathing found improved PHQ-9 scores in patients compliant with CPAP therapy and a greater improvement in patients with a baseline PHQ-9 higher than 10 (moderate severity). 18 ■ METABOLIC SYNDROME OSA is associated with metabolic disorders, including metabolic syndrome, though the causality between these 2 conditions is yet to be illuminated. Metabolic syndrome is a term used when an individual has 3 or more of the following features or conditions:…”

Section: ■ Drowsy Drivingmentioning

confidence: 99%

Beyond heart health: Consequences of obstructive sleep apnea

Walia

2019

CCJM

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Obstructive sleep apnea (OSA) is a serious condition associated with impaired quality of life, depression, drowsy driving and motor vehicle accidents, metabolic disease, and cognitive decline. The mechanisms accounting for OSA and metabolic disease include hypoxia, sleep fragmentation, and systemic infl ammation. OSA appears to advance cognitive decline, and the relationship between the 2 conditions may be bidirectional. Treatment of patients with continuous positive air pressure therapy improves many of the impaired outcomes associated with OSA. Greater awareness, screening, and treatment of patients with OSA can reduce the negative consequences associated with OSA.

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Depression score changes in response to sleep disordered breathing treatment with positive airway pressure in a large clinic-based cohort

Abstract: PAP therapy and adherence were associated with improvement in depressive symptom severity in this clinical cohort. Patients with lower socioeconomic status derived less therapeutic benefit, suggesting that they faced additional barriers to treatment effectiveness.

Cited by 4 publications

References 33 publications

Insomnia symptoms mediate the association between eveningness and suicidal ideation, defeat, entrapment, and psychological distress in students

Insomnia symptoms mediate the association between eveningness and suicidal ideation, defeat, entrapment, and psychological distress in students

Does continuous positive airways pressure treatment improve clinical depression in obstructive sleep apnea? A randomized wait‐list controlled study

Beyond heart health: Consequences of obstructive sleep apnea

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