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Obstructive Sleep Apnea and Depression

Published online by Cambridge University Press:  07 November 2014


Is there an association between obstructive sleep apnea (OSA) and depression? OSA is a common breathing-related sleep disorder. There have been reports that depressive symptoms can be associated with this sleep disorder. A number of investigations have addressed this issue. Although some have found no correlation, most studies have concluded that there is an association between OSA and depressive symptoms. Other investigations have shown that depressive symptoms improve with treatment of OSA, and that untreated OSA may contribute to treatment resistance in some cases of mood disorders. Within the framework of current psychiatric diagnostic criteria, the depressive symptoms associated with OSA can be viewed as a combination of a mood disorder secondary to a primary medical condition and an adjustment disorder with depressed mood. The question of whether OSA causes depressive symptoms can perhaps be best answered by viewing OSA and depression as having certain symptoms that are common to both disorders.

Copyright © Cambridge University Press 2003

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1.Martin, SE, Brander, PE, Deary, IJ, Douglas, NJ. The effect of clustered versus regular sleep fragmentation on daytime function. J Sleep Res. 1999;8:305311.Google Scholar
2.Martin, SE, Engleman, HM, Deary, IJ, Douglas, NJ. The effect of sleep fragmentation on daytime function. Am J Respir Crit Care Med. 1996;153(4 pt 1):13281332.Google Scholar
3.Wu, JC, Bunney, WE. The biological basis of an antidepressant response to sleep deprivation and relapse: review and hypothesis. Am J Psychiatry. 1990;147:1421.Google Scholar
4.Gillin, JC, Buchsbaum, M, Wu, J, Clark, C, Bunney, W Jr.Sleep deprivation as a model experimental antidepressant treatment: findings from functional brain imaging. Depress Anxiety. 2001;14:3749.Google Scholar
5.Guilleminault, C, Eldridge, FL, Tilkian, A, Simmons, FB, Dement, WC. Sleep apnea syndrome due to upper airway obstruction: a review of 25 cases. Arch Intern Med. 1977;137:296300.Google Scholar
6.Beutler, LE, Ware, JC, Karacan, I, Thornby, JI. Differentiating psychological characteristics of patients with sleep apnea and narcolepsy. Sleep. 1981;4:3947.Google Scholar
7.Cheshire, K, Engleman, H, Deary, I, Shapiro, C, Douglas, NJ. Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome. Arch Intern Med. 1992;152:538541.Google Scholar
8.Ramos Platon, MJ, Espinar Sierra, J. Changes in psychopathological symptoms in sleep apnea patients after treatment with nasal continuous positive airway pressure. Int J Neurosci. 1992;62:173195.Google Scholar
9.Reynolds, CF 3rd, Kupfer, DJ, McEachran, AB, Taska, LS, Sewitch, DE, Coble, PA. Depressive psychopathology in male sleep apneics. J Clin Psychiatry. 1984;45:287290.Google Scholar
10.Aikens, JE, Vanable, PA, Tadimeti, L, Caruana-Montaldo, B, Mendelson, WB. Differential rates of psychopathology symptoms in periodic limb movement disorder, obstructive sleep apnea, psychophysiological insomnia, and insomnia with psychiatric disorder. Sleep. 1999;22:775780.Google Scholar
11.Aikens, JE, Mendelson, WB. A matched comparison of MMPI responses in patients with primary snoring or obstructive sleep apnea. Sleep. 1999;22:355359.Google Scholar
12.Aikens, JE, Caruana-Montaldo, B, Vanable, PA, Tadimeti, L, Mendelson, WB. MMPI correlates of sleep and respiratory disturbance in obstructive sleep apnea. Sleep. 1999;22:362369.Google Scholar
13.Bardwell, WA, Moore, P, Ancoli-Israel, S, Dimsdale, JE. Does obstructive sleep apnea confound sleep architecture findings in subjects with depressive symptoms? Biol Psychiatry. 2000;48:10011009.Google Scholar
14.Bliwise, DL, Yesavage, JA, Sink, J, Widrow, L, Dement, WC. Depressive symptoms and impaired respiration in sleep. J Consult Clin Psychol. 1986;54:734735.Google Scholar
15.Bardwell, WA, Ancoli-Israel, S, Dimsdale, JE. Types of coping strategies are associated with increased depressive symptoms in patients with obstructive sleep apnea. Sleep. 2001;24:905909.Google Scholar
16.Pillar, G, Lavie, P. Psychiatric symptoms in sleep apnea syndrome: effects of gender and respiratory disturbance index. Chest. 1998;114:697703.Google Scholar
17.Bardwell, WA, Berry, CC, Ancoli-Israel, S, Dimsdale, JE. Psychological correlates of sleep apnea. J Psychosom Res. 1999;47:583596.Google Scholar
18.Millman, RP, Fogel, BS, McNamara, ME, Carlisle, CC. Depression as a manifestation of obstructive sleep apnea: reversal with nasal continuous positive airway pressure. J Clin Psychiatry. 1989;50:348351.Google Scholar
19.Derderian, SS, Bridenbaugh, RH, Rajagopal, KR. Neuropsychologic symptoms in obstructive sleep apnea improve after treatment with nasal continuous positive airway pressure. Chest. 1988;94:10231027.Google Scholar
20.Engleman, HM, Martin, SE, Deary, IJ, Douglas, NJ. Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet. 1994;343:572575.Google Scholar
21.Sanchez, AI, Buela-Casal, G, Bermudez, MP, Casas-Maldonado, F. The effects of continuous positive air pressure treatment on anxiety and depression levels in apnea patients. Psychiatry Clin Neurosci. 2001;55:641646.Google Scholar
22.Edinger, JD, Carwile, S, Miller, P, Hope, V, Mayti, C. Psychological status, syndromatic measures, and compliance with nasal CPAP therapy for sleep apnea. Percept Mot Skills. 1994;78(3 pt 2):11161118.Google Scholar
23.Klonoff, H, Fleetham, J, Taylor, DR, Clark, C. Treatment outcome of obstructive sleep apnea. Physiological and neuropsychological concomitants. J Nerv Ment Dis. 1987;175:208212.Google Scholar
24.Mosko, S, Zetin, M, Glen, S, et al.Self-reported depressive symptomatology, mood ratings, and treatment outcome in sleep disorders patients. J Clin Psychol. 1989;45:5160.Google Scholar
25.Borak, J, Cieslicki, JK, Koziej, M, Matuszewski, A, Zielinski, J. Effects of CPAP treatment on psychological status in patients with severe obstructive sleep apnoea. J Sleep Res. 1996;5:123127.Google Scholar
26.American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
27.Kales, A, Caldwell, AB, Cadieux, RJ, et al.Severe obstructive sleep apnea-—II: Associated psychopathology and psychosocial consequences, J Chronic Dis. 1985;38:427434.Google Scholar
28.Stepnowsky, C, Johnson, S, Dimsdale, J, Ancoli-Israel, S. Sleep apnea and health-related quality of life in African-American elderly. Ann Behav Med. 2000;22:116120.Google Scholar
29.Lee, S. Depression in sleep apnea: a different view. J Clin Psychiatry. 1990;51:309310.Google Scholar
30.Reynolds, CF 3rd, Coble, PA, Spiker, DG, et al.Prevalence of sleep apnea and nocturnal myoclonus in major affective disorders: clinical and polysomnographic findings. J Nerv Ment Dis. 1982;170:565567.Google Scholar
31.Kaplan, R. Obstructive sleep apnoea and depression-diagnostic and treatment implications. Aust N Z J Psychiatry. 1992;26:586591.Google Scholar
32.Fleming, JA, Fleetham, JA, Taylor, DR, Remick, RA. A case report of obstructive sleep apnea in a patient with bipolar affective disorder. Can J Psychiatry. 1985;30:437439.Google Scholar
33.Guilleminault, C, Stoohs, R, Clerk, A, Cetel, M, Maistros, P. A cause of excessive daytime sleepiness. The upper airway resistance syndrome. Chest. 1993;104:781787.Google Scholar