The Comorbid between Depression and Obstructive Sleep Apnea

Main Article Content

Chotiman Chinvararak
Diego Garcia-Borreguero

Abstract

Depression and Obstructive sleep apnea (OSA) are common disorders in clinical practice. There are many overlapping symptoms of depression and OSA, such as insomnia, fatigue, daytime sleepiness, and poor concentration. Each disorder can affect the other bi-directionally. A comprehensive assessment, including history taking, upper airway evaluation and sleep test, is mandatory when physicians suspect these comorbid conditions. Currently, there is no treatment guideline for comorbid depression and OSA; however, parallel treatment with the standards of each disorder should be provided to patients to achieve better therapeutic outcomes. 

Article Details

How to Cite
Chinvararak, C., & Garcia-Borreguero, D. (2023). The Comorbid between Depression and Obstructive Sleep Apnea. Journal of the Psychiatric Association of Thailand, 68(4), 422–427. Retrieved from https://he01.tci-thaijo.org/index.php/JPAT/article/view/264216
Section
Review Articles

References

WHO. The global burden of disease: 2004 update. Geneva: World Health Organization, 2008

Read JR, Sharpe L, Modini M, Dear BF. Multimorbidity and depression: a systematic review and meta-analysis. J Affect Disord 2017;221:36-46.

Doi: 10.1016/j.jad.2017.06.009. Epub 2017 Jun 14. PMID: 28628766.

Malhi GS, Mann JJ. Depression. Lancet 2018;392(10161):2299-312.

Doi: 10.1016/S0140-6736(18)31948-2. Epub 2018 Nov 2. PMID: 30396512.

Rundo JV. Obstructive sleep apnea basics. Cleve Clin J Med 2019;86(9 Suppl 1):2-9.

Doi: 10.3949/ccjm.86.s1.02. PMID: 31509498

Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, et al. Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 2017; 34:70-81. Doi: 10.1016/j.smrv.2016.07.002. Epub 2016 Jul 18. PMID: 27568340.

Lajoie AC, Lafontaine AL, Kimoff RJ, Kaminska M. Obstructive sleep apnea in neurodegenerative disorders: current evidence in support of benefit from sleep apnea treatment. J Clin Med 2020;9(2):297. Doi: 10.3390/jcm9020297. PMID: 31973065; PMCID: PMC7073991.

Walia HK. Beyond heart health: Consequences of obstructive sleep apnea. Cleve Clin J Med 2019;86(9 Suppl 1):19-25. Doi: 10.3949/ccjm.86.s1.04. PMID: 31509500.

Kerner NA, Roose SP. Obstructive sleep apnea is linked to depression and cognitive impairment: evidence and potential mechanisms. Am J Geriatr Psychiatry 2016;24(6):496-508. Doi: 10.1016/j.jagp.2016.01.134. Epub 2016 Apr 29. PMID: 27139243; PMCID: PMC5381386.

Jehan S, Auguste E, Pandi-Perumal SR, Kalinowski J, Myers AK, Zizi F, et al. Depression, obstructive sleep apnea and psychosocial health. Sleep Med Disord 2017;1(3):00012. Epub 2017 Oct 27. PMID: 29517078; PMCID: PMC5836734.

Ejaz SM, Khawaja IS, Bhatia S, Hurwitz TD. Obstructive sleep apnea and depression: a review. Innov Clin Neurosci 2011;8(8):17-25.

Harris M, Glozier N, Ratnavadivel R, Grunstein RR. Obstructive sleep apnea and depression. Sleep Med Rev 2009;13(6):437-44. Doi: 10.1016/j.smrv.2009.04.001. Epub 2009 Jul 10. PMID: 19596599.

Gupta MA, Simpson FC. Obstructive sleep apnea and psychiatric disorders: a systematic review. J Clin Sleep Med 2015;11(2):165-75. Doi: 10.5664/jcsm.4466. PMID: 25406268; PMCID: PMC4298774.

Tiensuntisook S, Awiruthworakul T. Correlation between severity of obstructive sleep apnea and depression. J Psychiatr Assoc Thailand 2016; 61(1): 63-74.

Fang H, Tu S, Sheng J, Shao A. Depression in sleep disturbance: a review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med 2019;23(4):2324-32. Doi: 10.1111/jcmm.14170. Epub 2019 Feb 7. PMID: 30734486; PMCID: PMC6433686.

Pan ML, Tsao HM, Hsu CC, Wu KM, Hsu TS, Wu YT, et al. Bidirectional association between obstructive sleep apnea and depression: a population-based longitudinal study. Medicine (Baltimore) 2016;95(37):e4833. Doi: 10.1097/MD.0000000000004833. PMID: 27631236; PMCID: PMC5402579.

Winokur A. The relationship between sleep disturbances and psychiatric disorders: introduction and overview. Psychiatr Clin North Am 2015;38(4):603-14. Doi: 10.1016/j.psc.2015.07.001. PMID: 26600099.

Sutton EL. Psychiatric disorders and sleep issues. Med Clin North Am 2014;98(5):1123-43. Doi: 10.1016/j.mcna.2014.06.009. Epub 2014 Jul 22. PMID: 25134876.

Grandner MA, Malhotra A. Connecting insomnia, sleep apnoea and depression. Respirology 2017;22(7):1249-50. Doi:10.1111/resp.13090

Baglioni C, Nanovska S, Regen W, Spiegelhalder K, Feige B, Nissen C, et al. Sleep and mental disorders: a meta-analysis of polysomnographic research. Psychol Bull 2016;142(9):969-90. Doi: 10.1037/bul0000053. Epub 2016 Jul 14. PMID: 27416139; PMCID: PMC5110386.

Krystal AD. Psychiatric disorders and sleep. Neurol Clin 2012;30(4):1389-413. Doi:10.1016/j.ncl.2012.08.018

Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, et al. Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009;5(3):263-76.

Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 2019;15(2):335-43.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington: American Psychiatric Publishing; 2013.

Levis B, Benedetti A, Thombs BD. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ 2019;365:l1476. Doi: 10.1136/bmj.l1476. Erratum in: BMJ. 2019 Apr 12;365:l1781. PMID: 30967483; PMCID: PMC6454318.

Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 1988;8:77-100.

Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23:56–62

Davidson J, Turnbull CD, Strickland R, Miller R, Graves K. The Montgomery-Asberg Depression Scale: reliability and validity. Acta Psychiatr Scand 1986;73(5):544-8. Doi: 10.1111/j.1600-0447.1986.tb02723.x. PMID: 3751660.

Jackson ML, Tolson J, Schembri R, Bartlett D, Rayner G, Lee VV, et al. Does continuous positive airways pressure treatment improve clinical depression in obstructive sleep apnea? a randomized wait-list controlled study. Depress Anxiety 2021;38(5):498-507. Doi: 10.1002/da.23131. Epub 2020 Dec 28. PMID: 33368782.

Zheng D, Xu Y, You S, Hackett ML, Woodman RJ, Li Q, et al. Effects of continuous positive airway pressure on depression and anxiety symptoms in patients with obstructive sleep apnoea: results from the sleep apnoea cardiovascular Endpoint randomized trial and meta-analysis. EclinicalMedicine 2019;11:89-96. Doi: 10.1016/j.eclinm.2019.05.012. PMID: 31312807; PMCID: PMC6610775.

Bargalló N, Bartrés-Faz D, Montserrat JM. Effect of CPAP on cognition, brain function, and structure among elderly patients with OSA: a randomised pilot study. Chest 2015;148(5):1214-23. Doi: 10.1378/chest.15-0171. PMID: 26065720.

Povitz M, Bolo CE, Heitman SJ, Tsai WH, Wang J, James MT. Effect of treatment of obstructive sleep apnea on depressive symptoms: systematic review and meta-analysis. PloS Med 2014;11(11):e1001762. Doi: 10.1371/journal.pmed.1001762. PMID: 25423175; PMCID: PMC4244041.

de Mendonça FMR, de Mendonça GPRR, Souza LC, Galvão LP, Paiva HS, de Azevedo Marques Périco C, et al. Benzodiazepines and sleep architecture: a systematic review. CNS Neurol Disord Drug Targets 2021;17. Doi: 10.2174/1871527320666210618103344. Epub ahead of print. PMID: 34145997.

Wang D, Tang Y, Chen Y, Zhang S, Ma D, Luo Y, et al. The effect of non-benzodiazepine sedative hypnotics on CPAP adherence in patients with OSA: a systematic review and meta-analysis. Sleep 2021;44(8):zsab077. Doi: 10.1093/sleep/zsab077. PMID: 33769549.

Abdel Fattah MR, Jung SW, Greenspan MA, Padilla M, Enciso R. Efficacy of antidepressants in the treatment of obstructive sleep apnea compared to placebo. a systematic review with meta-analyses. Sleep Breath 2020;24(2):443-53. Doi: 10.1007/s11325-019-01954-9. Epub 2019 Nov 12. PMID: