Depression and obstructive sleep apnea share some common symptoms, due to which physicians often tend to get confused in the correct diagnosis. Obstructive sleep apnea (OSA) occurs when the tongue or throat muscles relax too much during sleep and block the airway. This can happen more than 50 times an hour during sleep, causing snoring and pauses in breathing that last as long as 60 seconds. The problem is twice as common in men, and it afflicts more than 12 million Americans, according to the National Institutes of Health. Sleep apnea is usually treated by wearing a mask or using a specially designed nasal device that delivers air under slight pressure, keeping the airway open so that the patient can breathe normally.
A study was undertaken at The Sleep Center at University Community Hospital, Tampa, FL to assess the reversibility of symptoms of depression using continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA). The findings, published in the September issue of the journal Chest, report that many patients with depression symptoms improved markedly when treated with continuous positive airway pressure, or CPAP therapy, the standard treatment for sleep apnea.
Patients referred to our center for evaluation of OSA who had a respiratory disturbance index (RDI) and who demonstrated a significant response to CPAP were evaluated for the symptoms of depression using the Beck Depression Inventory (BDI), and then reassessed after 4 to 6 weeks of treatment with CPAP at home. In this group of patients, the institution of CPAP therapy resulted in a significant decrease in those symptoms of depression. This change in was noted both in those individuals who had received an antidepressant prescription prior to referral, and in those who had not.
However, the authors warn that this finding does not necessarily apply to all patients with depression, and conversely, not everyone who has depression symptoms should automatically be evaluated for a sleep disorder. It is quite possible that depression and sleep apnea share the same underlying mechanisms, or that obstructive sleep apnea is itself a cause of depression.
It is suggested that patients under depression should disclose symptoms suggestive of obstructive sleep apnea to their physicians. In some of these individuals, the symptoms of depression may be ameliorated with CPAP.