Depression and Obstructive Sleep Apnea
It is estimated that over 22 million Americans suffer from sleep apnea, a sleep health condition defined by abnormal breathing during sleep. The most common type of sleep apnea, obstructive sleep apnea, occurs when the airway at the back of the throat becomes blocked, leading to continual interruptions in breathing. The comorbidities associated with untreated OSA include cardiovascular disease, hypertension, and diabetes. While these comorbidities have been well researched and documented, new mental health research reveals that depressive symptoms are highly prevalent in people with obstructive sleep apnea.
According to Healthline, over 16 million people in the United States suffer from depression, and over 75 percent of people with depression have some form of sleep disorder. There is a reciprocal relationship between depression and obstructive sleep apnea: depression symptoms can affect your sleep, and sleep apnea symptoms may also lead to depression. This relationship is further complicated by the overlapping of symptoms that exist between the two conditions. The common symptoms of OSA include excessive daytime sleepiness, brain fog, headaches, irritability, and difficulty sleeping at night. The symptoms of depression include being easily frustrated, irritability, fatigue, headaches, and difficulty focusing.
One of the first studies linking sleep-disordered breathing with depression was done by The Centers for Disease Control and Prevention (CDC) in April of 2012. The study included over 9,700 participants and was the largest and most nationally representative sample to look at obstructive sleep apnea and depression. The study's authors found that the incidence of depression increased with the prevalence of the disrupted breathing, a classic symptom of sleep apnea. Possible explanations for the OSA / depression connection include a lack of oxygen in the blood and the resulting build-up of carbon dioxide. Researchers at the UCLA School of Nursing found that brain neurotransmitters, which act as chemical messengers in the brain, are at lower levels in patients with OSA. These neurotransmitters are associated with mood and the creation of endorphins.
Additionally, obstructive sleep apnea disrupts the architecture or stages of our sleep. Getting enough high quality, uninterrupted sleep is important because the brain processes emotional information during the sleep cycle. Research is proving that a lack of sleep is especially harmful to the consolidation of positive memories and can influence mood, all tying back to the risk of depression and other mental health conditions.
Physicians are successfully treating patients who test positive for obstructive sleep apnea and also exhibit depressive symptoms by using Continuous Positive Airway Pressure therapy. CPAP is the gold standard in the treatment of obstructive sleep apnea and works by using pressurized air that flows through a mask and tubing, resulting in continually opened airways. A recent study reported in the Journal of Clinical Sleep Medicine tested the effectiveness of CPAP on OSA patients experiencing depressive symptoms. Using a sample of over 200 patients, the study revealed that with dedicated CPAP usage of 3 months, only 4 percent of the participants had remaining significant depressive symptoms. While the connection between obstructive sleep apnea and depression is bidirectional, it further elevates sleep's critical role in both our physical and mental health.
To learn more about how BetterNight can help you provide more effective and efficient care to your at-risk sleep apnea patients, contact us.