Thursday, November 1, 2007

Wham: Sleep Apnea and Depression May Be Related in Some Patients

Scientists have discovered that the use of a breathing treatment called continuous positive airway pressure may improve depressive symptoms in patients with obstructive sleep apnea. This study was described in the Journal of Clinical Sleep Medicine.

Obstructive sleep apnea is frequently seen in individuals who are obese and those who snore. It is a common problem in which patients stop breathing for short periods during sleep, and it occurs because soft tissues in the back of the throat relax and temporarily block the airway.

With continuous positive airway pressure (CPAP), the patient wears a special mask that continuously blows air into the throat, preventing the tissues from collapsing. You may have seen this strange device; those who use it report that while it is difficult to get used to, once adjusted to the change in sleep it offers a marvelous improvement in getting a good night's rest.

Dr. Daniel J. Schwartz, lead author from the Sleep Center at University Community Hospital in Tampa, said, "Symptoms which might otherwise be ascribed to depression -- feelings of sadness, discouragement about the future, feelings of excessive personal failures, perceived decreases in self-confidence, a sense of being overly self-critical, the inability to derive pleasure from things, and even suicidal thoughts -- may at times be attributable to obstructive sleep apnea, an easily treatable medical illness."

In an earlier study of 50 obstructive sleep apnea patients, 32 of whom had symptoms of depression at enrollment, the researchers noted a marked improvement in standard depression test scores after initiation of in-home CPAP therapy. Their latest assessment of these patients, conducted about 1 year after the initiation of CPAP, shows that ongoing CPAP therapy is associated with sustained improvement in depressive symptoms.

It is entirely possible that at least some patients being treated with antidepressant medications such as SSRI's -- those whose symptoms are due to obstructive sleep apnea -- might be better served with this airway therapy.

Dave Jensen

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