Abstract
Obstructive Sleep Apnea (OSA) is the most frequent sleep-related breathing disorder. Excessive daytime sleepiness is usually a recurrent complaint in OSA patients, and continuous positive airway pressure (CPAP) may not be fully efficient in treating it. Previous studies have found association between depression and OSA, with a variable prevalence. Symptoms of both diseases may overlap, and their incorrect interpretation may hinder treatment. The aim was to determine the frequency of presentation and severity of depression and describe its relationship with excessive daytime sleepiness in patients with OSA. 345 adult patients with OSAS diagnosed by polysomnography were assessed in a cross-sectional study. The participants filled the 9-item Patient Health Questionnaire (PHQ-9) for screening of depressive symptoms. Excessive daytime sleepiness was assess with the Epworth Sleepiness Scale. Demographic data, Apnea-Hypopnea (AHI), arousal and body mass index (BMI) were collected. 37.1% patients showed risk depressive symptoms, 34.8% showed scores compatible with depression. Severity of depression correlated directly with severity of daytime sleepiness (0.264, p=0.01). BMI correlated directly with severity of AHI (0.316, p=0.01) and arousal index (0.173, p=0.01). Average oxygen saturation was inversely related to the severity of AHI (-0,457, p=0.01). OSA patients have an increased frequency and severity of depression than those of general population, and depression is independently associated with increased daytime sleepiness. Depression screening should be indicated in all patients with OSA, especially those in whom daytime sleepiness persists despite CPAP treatment, before considering wake-promoting drugs.
- © 2013 ERS