Effect of CPAP on depressive symptoms in OSA

Abstract

Background: Obstructive sleep apnea syndrome (OSAS) is a common disease, affecting about 2–4% of the adult population. Some of the symptoms of OSAS resemble symptoms associated with anxiety and depressive conditions in untreated OSAS, rates of depression are elevated compared with general populations, studies of (CPAP) treatment in OSAS have shown an improvement in symptoms of depression. Aim: To assess depression in patients with obstructive sleep apnea syndrome (OSAS), and the effect of CPAP on it. Patients and methods: This study comprised 30 cases who underwent full history taking, general and local examinations, assessment of daytime sleepiness by Epworth scale, overnight polysomnography using (Embla S 4000, Iceland) and assessment of depression before and 2 month after treatment with CPAP by The Hamilton Depression Rating Scale (HDRS), The Structured Clinical Interview for DSM-IV (SCID) and BECK scale for depression. Results: The mean age of patients was 55 years. Sixteen patients had HDRS scores above the cut-off point of the scale of ten (indicating some sort of depression). After that patients were subjected to SCID. Ten patients (33.3%) fulfilled the clinical diagnosis of a major depressive disorder according to DSM-IV and after CPAP treatment for two months resulted in significant improvements of depressive symptoms in both BDI and HRSD scores. The BDI score decreased from 18.6 ± 9.2 to 9.4 ± 10.1, while the HRSD score decreased from 14.1 ± 8.5 to 7.9 ± 7.2 (both p < 0.01). Conclusion: OSA is associated with depression which improved after CPAP treatment.

Keywords

• OSA
• SCID
• HRSD
• BDI
• Polysomnography