Sleep-Related Breathing Disorders and Mood Disorders

Hashmi, Ali Madeeh; Giray, Nilgun; Hirshkowitz, Max

doi:10.1016/j.jsmc.2006.11.001

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Although 37.5% had BDI scores in the "clinically significant range" of 15 or more, there was no difference between this group and those with lower BDI scores for either AHI or SaO2 nadir, and no non-significant trends. 10 A Polish study (n=63) also found no significant differences between men with and without OSA for BDI or CES-D (with mean BDI scores highest in the control group). 43 Another study of Hamilton Hospital Anxiety and Depression Scale depression (HAD-D) scores in 44 Swiss OSA patients and 16 snorers found no significant correlation with AHI (and a trend, p=0.06, towards a negative relationship) but did find a significant positive correlation between mean low oxygen saturation and HAD-D score.…”

Section: Relationships In Severity Of Disease -Cross Sectional Studiesmentioning

confidence: 91%

“…[6][7][8] Attempts to overcome the difficulty of measuring depressive symptoms where OSA is likely to produce similar symptoms range from study-specific modifications to existing scales 9 to suggestions that only cognitive features of depression, such as feelings of guilt or worthlessness, self-blame ruminative thoughts and crying, should be used in OSA. 10 While commonly used depression scales have been validated for various patient groups, specifically the HAD-D 11 there do not appear to be validation studies in OSA despite the frequent assessment of mood in OSA research. It appears that studies are needed to evaluate the validity of various depression scales, and variants, in OSA.…”

Section: Definition and Measurement Issuesmentioning

confidence: 99%

“…Obesity is the most commonly suggested confounder but depression and obesity do not have a straightforward or consistent association, 20 as has also been found in some OSA populations. 10 Any confounding by body mass index (BMI) may operate differently for men and women. Aloia and colleagues 7 measured sleep variables, BMI and depressive symptoms in a group of men and women with moderate to severe OSA (clinician diagnosed) and without major psychiatric disorder.…”

Section: Possible Confounders and Effect Modifiers Affecting Prevalenmentioning

confidence: 99%

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Obstructive sleep apnea and depression

Harris

Glozier

Ratnavadivel

et al. 2009

Sleep Medicine Reviews

273

195

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Phone +61 2 9515 8630 Fax +61 2 9515 7070 For correspondence Dr Harris can now be contacted at melanie.harris@unisa.edu.au.Please cite this as: . Obstructive sleep apnea and depression. Sleep Medicine Reviews, 13(6), 437-444. doi:10.1016437-444. doi:10. /j.smrv.2009437-444. doi:10. .04.001 Copyright 2009 Elsevier.Archived at Flinders University: dspace.flinders.edu.au AbstractThere are high rates of depression in people with obstructive sleep apnea (OSA) in both community and clinical populations. A large community study reported a rate of 17% and reports for sleep clinic samples range between 21% and 41%. A large cohort study found OSA to be a risk factor for depression, but we are unaware of any longitudinal study of the reverse association. However correlations have not generally been found in smaller studies. Well-designed longitudinal studies are needed to examine temporal relationships between the two conditions and further research is needed to establish the role of confounders, and effect modifiers such as gender, in any apparent relationship. Symptoms common to OSA and depression, such as sleepiness and fatigue, are obstacles to determining the presence and severity of one condition in the presence of the other, in research and clinically. Sleep clinicians are advised to consider depression as a likely cause of sleepiness and fatigue. Several possible causal mechanisms linking OSA and depression have been proposed but not established. Patients who have depression as well as OSA appear worse off than those with OSA only, and depressive symptoms persist in at least some patients in short term studies of treatment for OSA. Direct treatment of depression in OSA might improve acceptance of therapy, reduce sleepiness and fatigue and improve quality of life, but intervention trials are required to answer this question.

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Section: Relationships In Severity Of Disease -Cross Sectional Studiesmentioning

confidence: 91%

Section: Definition and Measurement Issuesmentioning

confidence: 99%

Section: Possible Confounders and Effect Modifiers Affecting Prevalenmentioning

confidence: 99%

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Obstructive sleep apnea and depression

Harris

Glozier

Ratnavadivel

et al. 2009

Sleep Medicine Reviews

273

195

View full text Add to dashboard Cite

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“…6 In patients with a sleep disorder, the prevalence of depression has been reported to be 17.6% 7 ; in patients with OSA in particular, its prevalence is even higher, ranging from approximately 20% to 40% when assessed using the Beck Depression Inventory. 5,8,9 Progression of OSA has been found to be associated with an increased risk of developing depression. 10 Even patients with mild OSA are 60% more likely to become depressed than individuals without this sleep disorder.…”

Section: Depression In Patients With Osamentioning

confidence: 99%

“…The mechanism that underlies this relationship has yet to be clearly delineated, although the effects on mood of sleep fragmentation and intermittent hypoxia may play a substantive role in the etiology of depression in patients with OSA. 8,10 Indeed, 1 study has reported that the severity of psychological symptoms associated with OSA was negatively related to total sleep time and the percentage of stage 2 nonrapid eye movement sleep. 58 In addition to CPAP therapy, it is important to prescribe suitable treatment for depression in patients with OSA who have this comorbidity to reduce both the mood disturbance and associated fatigue.…”

Section: Confirmation Of Initial Diagnosismentioning

confidence: 99%

Recognizing and Managing Obstructive Sleep Apnea in Primary Care

Culpepper¹,

Roth²

2009

Prim. Care Companion J. Clin. Psychiatry

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Objective: This review aims to impart information regarding recognition of obstructive sleep apnea (OSA) and associated excessive sleepiness (ES) in the primary care setting in order to provide optimal care to patients with this common but serious condition. This review will also discuss the prevalence and treatment of depression in patients with OSA.Data Sources: A MEDLINE search of articles published between 1990 and 2008 was conducted using the search terms obstructive sleep apnea AND excessive sleepiness, obstructive sleep apnea AND depression, and obstructive sleep apnea AND primary care. Searches were limited to articles in English concerned with adult patients.Study Selection: In total, 239 articles were identified. Articles concerning other sleep disorders and forms of apnea were excluded. The reference lists of identified articles were searched manually to find additional articles of interest.Data Synthesis: Primary care physicians can aid in the diagnosis of OSA and associated ES by being vigilant for lifestyle and physical risk factors associated with this condition. In addition, primary care physicians should maintain a high level of clinical suspicion when presented with illnesses that are commonly comorbid with OSA, such as psychiatric disorders and depression, in particular. Conversely, assessment of patients with OSA for common comorbidities may also improve a patient's prognosis and quality of life.Conclusions: Primary care physicians play a vital role in recognizing OSA and ES. These clinicians are crucial in supporting their patients during treatment by ensuring that they have clear, concise information regarding available therapies and the correct application and maintenance of prescribed devices.

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