CPAP can help adults with sleep apnea and depressive symptoms

Depressive symptoms in adults with sleep apnea are improved when the person uses a CPAP.

A new study shows that depressive symptoms are extremely common in people who have obstructive sleep apnea, and these symptoms improve significantly when sleep apnea is treated with continuous positive airway pressure therapy.

Results show that nearly 73 percent of sleep apnea patients (213 of 293 patients) had clinically significant depressive symptoms at baseline, with a similar symptom prevalence between men and women. These symptoms increased progressively and independently with sleep apnea severity.

However, clinically significant depressive symptoms remained in only 4 percent of the sleep apnea patients who adhered to CPAP therapy for 3 months (9 of 228 patients). Of the 41 treatment adherent patients who reported baseline feelings of self-harm or that they would be "better dead," none reported persisting suicidal thoughts at the 3-month follow-up.

"Effective treatment of obstructive sleep apnea resulted in substantial improvement in depressive symptoms, including suicidal ideation," said senior author David R. Hillman, MD, clinical professor at the University of Western Australia and sleep physician at the Sir Charles Gairdner Hospital in Perth. "The findings highlight the potential for sleep apnea, a notoriously underdiagnosed condition, to be misdiagnosed as depression."

Study results are published in the September issue of the Journal of Clinical Sleep Medicine.

The American Academy of Sleep Medicine reports that obstructive sleep apnea (OSA) is a common sleep disease afflicting at least 25 million adults in the U.S. Untreated sleep apnea increases the risk of other chronic health problems including heart disease, high blood pressure, Type 2 diabetes, stroke and depression.

The study group comprised 426 new patients referred to a hospital sleep center for evaluation of suspected sleep apnea, including 243 males and 183 females. Participants had a mean age of 52 years. Depressive symptoms were assessed using the validated Patient Health Questionnaire (PHQ-9), and the presence of obstructive sleep apnea was determined objectively using overnight, in-lab polysomnography. Of the 293 patients who were diagnosed with sleep apnea and prescribed CPAP therapy, 228 were treatment adherent, which was defined as using CPAP therapy for an average of 5 hours or more per night for 3 months.

According to the authors, the results emphasize the importance of screening people with depressive symptoms for obstructive sleep apnea. These patients should be asked about common sleep apnea symptoms including habitual snoring, witnessed breathing pauses, disrupted sleep, and excessive daytime sleepiness.

Read more here

---

Study: Moderate exercise prevents depression

Research shows that exercise can both prevent and treat depression. 

Physical activity is being increasingly recognized as an effective tool to treat depression. PhD candidate George Mammen's review published in the October issue of theAmerican Journal of Preventive Medicine has taken the connection one step further, finding that moderate exercise can actually prevent episodes of depression in the long term.

This is the first longitudinal review to focus exclusively on the role that exercise plays in maintaining good mental health and preventing the onset of depression later in life.

Mammen -- who is supervised by Professor Guy Faulkner, a co-author of the review -- analyzed over 26 years' worth of research findings to discover that even low levels of physical activity (walking and gardening for 20-30 minutes a day) can ward off depression in people of all age groups.

Mammen's findings come at a time when mental health experts want to expand their approach beyond treating depression with costly prescription medication. "We need a prevention strategy now more than ever," he says. "Our health system is taxed. We need to shift focus and look for ways to fend off depression from the start."

Mammen acknowledges that other factors influence a person's likelihood of experiencing depression, including their genetic makeup. But he says that the scope of research he assessed demonstrates that regardless of individual predispositions, there's a clear take-away for everyone. "It's definitely worth taking note that if you're currently active, you should sustain it. If you're not physically active, you should initiate the habit. This review shows promising evidence that the impact of being active goes far beyond the physical."

Read more here