Abstract
We evaluated whether obstructive sleep apnoea (OSA) was related to the incidence of hospitalisation for depression, a robust end-point that is unlikely to result from misdiagnosis.
All adults referred with suspected OSA who underwent a diagnostic sleep study at a large urban academic hospital between 1994 and 2010 and were linked to provincial health administrative data between 1991 and 2015 were included. Cox regression analysis was used to investigate the association between OSA symptoms and severity and incident hospitalised depression, the primary outcome.
Over a median follow-up of 9.7 years, 136 (1.3%) out of 10 149 participants were hospitalised for depression. A significant crude effect of OSA symptoms (waking unrefreshed and impact on memory and concentration) on hospitalised depression became nonsignificant after controlling for confounders. Apnoea–hypopnoea index was not significantly associated with the outcome: adjusted hazard ratio (33 versus 6 events·h−1) 1.13 (95% CI 0.91–1.40). Factors associated with hospitalised depression were female sex, younger age, use of hypnotics, alcoholism and unemployment.
In a large clinical cohort with suspected OSA, controlling for confounders, OSA symptoms and severity were not related to the risk of hospitalisation for depression, suggesting that previously reported links between OSA and depression may be due to overlapping diagnostic criteria. However, our findings cannot exclude a potential link between OSA and milder depression.
Abstract
Obstructive sleep apnoea has not been found to be associated with hospitalised depression http://ow.ly/sVW6309Muam
Footnotes
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Support statement: This project was supported by the ResMed Research Foundation. This study was supported by the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. T. Kendzerska is supported by the Canadian Respiratory Research Network (CRRN) Fellowship Training Award. Funding for training of graduate students and new investigators within the Network was supported by grants from the Canadian Institutes of Health Research (CIHR): Institute of Circulatory and Respiratory Health; Canadian Lung Association (CLA)/Canadian Thoracic Society (CTS); British Columbia Lung Association; and Industry Partners Boehringer-Ingelheim Canada Ltd, AstraZeneca Canada Inc., Novartis Canada Ltd. and GlaxoSmithKline Inc. The funding sponsors had no role in the study design, data collection and analysis, or preparation of the manuscript. Funding information for this article has been deposited with the Crossref Funder Registry.
Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com
- Received July 8, 2016.
- Accepted March 5, 2017.
- Copyright ©ERS 2017