Sleep Apnea & Depression: Not So Strange Bedfellows

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ots of talk over the past few years about sleep apnea, the disorder and treatment becoming much better understood. But what about its relationship with depression? Eh, not so much. So how ’bout we take the time to dig-in and learn…

As you may know, sleep apnea (SA) is a disorder featuring pauses or shallow breathing during sleep. Of note, an “apnea” is a quickly passing cessation of breathing. Now, the duration of each pause can be a few seconds, even a few minutes. And they can occur numerous times during a sleep period.

In the most common form of SA, obstructive sleep apnea (OSA), breathing is interrupted by a blockage of airflow, snoring often preceding. As normal breathing resumes, choking or snorting sounds may present.

Fact is, it’s not uncommon for an individual to be unaware the condition exists. And SA is most often diagnosed with a sleep study, more than five episodes per hour required for catching the diagnosis.

OSA presents in up to 6% of adults and 2% of children, and it hits males nearly twice as often as females. OSA typically presents in those ages 55-60, though any age is fair game. Risk factors include being overweight, a family history of SA, allergies, a small airway, sinus problems, and enlarged tonsils or tongue.

There are a variety of SA treatment options, including lifestyle changes, breathing devices (CPAP machine), mouthpieces, and surgery. Without treatment SA may increase the risk for heart attack, stroke, diabetes, heart failure, irregular heartbeat, obesity, and car accidents. Pertaining to car accidents, keep in mind, SA can generate excessive daytime sleepiness (EDS), impaired alertness, and vision problems.

Finally, the use of alcohol and sedatives (benzodiazepines, barbiturates) may promote SA by relaxing throat muscles. Also, smokers have SA at three times the rate of those who’ve never smoked.

The Depression Piece

A study was published in the Journal of Clinical Sleep Medicine several years ago by a crew from the University of Western Australia. Their work showed that 73% of those with SA experience symptoms of depression. Further, the greater the severity of SA, the higher the likelihood of depressive symptoms.

Now, the participants who were diagnosed with SA were offered CPAP therapy, five hours a night for three months. Those who adhered to the therapy experienced a significant reduction in depressive symptoms after three months. And when treatment was completed, only 4% of these participants had clinically significant symptoms of depression.

Even more, reported thoughts and feelings of self-harm or suicide hit the road.

The study crew believe their findings underscore the importance of screening depression sufferers for signs of SA. The final take-away from crew member Dr. David R. Hillman…

The findings highlight the potential for sleep apnea, a notoriously underdiagnosed condition, to be misdiagnosed as depression.

Let’s Wrap It Up

So, yes, sleep apnea and depression – not so strange bedfellows. And often, misdiagnosis is a major problem.

Why is that? I’d hold the following overlapping symptoms responsible: daytime sleepiness, fatigue/loss of energy, poor concentration, irritability, psychomotor retardation, and weight gain.

Do yourself a favor. If you’re experiencing depressive symptoms and have any reason to suspect you have sleep apnea…

Get it checked-out and treated!

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