Researchers Search for Link Between Sleep Apnea and Mood Disorders

Obstructive sleep apnea (OSA) has been linked with several health conditions including hypertension, cardiovascular disease, stroke, and type 2 diabetes.^1,2 Researchers set out to determine whether the syndrome might also increase the risk for mood disorders, including depression and anxiety.

Investigators Examine OSA and Affective Disorders

The researchers examined 197 patients with OSA diagnosed between 2004 and 2006 and 788 people without the condition matched for age, sex, and socioeconomic and health characteristics. None of the participants, selected from the Korea National Health Insurance Service-National Sample Cohort (NHIS-NSC), had been diagnosed with depressive or anxiety disorders before the first diagnosis of OSA.³

OSA Associated With Depression and Anxiety

The investigators found that people with OSA were nearly 3 times as likely to be diagnosed with depression, and nearly twice as likely to be diagnosed with anxiety as those in the control group. Of the cohort, women with OSA were more likely to develop depressive and anxiety disorders than men with OSA. Positive airway pressure and oral appliances used to treat OSA were not covered under the Korea NHIS-NSC, therefore the investigators were unable to determine if patients undergoing these therapies had a lower incidence of affective disorders.³

The investigators found that people with OSA were nearly 3 times as likely to be diagnosed with depression, and nearly twice as likely to be diagnosed with anxiety as those in the control group

The researchers concluded that OSA is associated with an increased risk for mood disorders, specifically depression and anxiety. They cautioned that further studies are needed to confirm their findings and explore possible underlying mechanisms, including potential causality.

A Growing Body of Evidence

Previous studies about OSA and affective disorders have yielded similar results. In 2014, researchers found that patients with OSA have higher rates of anxiety than the general population regardless of gender.⁴ In 2017, investigators concluded that moderate to severe OSA is a common pathology in major depression.⁵ Finally, earlier this year, scientists discovered that patients with OSA are more vulnerable to depression because the sleep disorder makes it difficult to recall details from the past.⁶

References

1. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008;5(2):136-143.
2. The dangers of uncontrolled sleep apnea. Johns Hopkins Medicine. Accessed October 8, 2019.
3. Kim J-Y, Ko I, Kim D-Y. Association of obstructive sleep apnea with the risk of affective disorders [published online September 12, 2019]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2019.2435
4. Rezaeitalab F, Moharrari F, Saberi S, Asadpour H, Rezaeetalab F. The correlation of anxiety and depression with obstructive sleep apnea syndrome. J Res Med Sci. 2014;19(3):205-210.
5. Hein M, Lanquart J-P, Loas G, Hubain P, Linkowski P. Prevalence and risk factors of moderate to severe obstructive sleep apnea syndrome in major depression: a observational and retrospective study on 703 subjects. BMC Pulm Med. 2017;17(1):165.
6. Delhikar N, Sommers L, Rayner G, et al. Autobiographical memory from different life stages in individuals with obstructive sleep apnea. J Int Neuropsychol Soc. 2019;25(3):266-274.