Sleep apnea treatment improves depression

NEW YORK (Reuters Health) - The use of a breathing treatment called continuous positive airway pressure may improve depressive symptoms in patients with obstructive sleep apnea, according to a study in the Journal of Clinical Sleep Medicine.

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

With continuous positive airway pressure (CPAP), the patient wears a special mask that continuously blows air into the throat, preventing the tissues from collapsing.

"The significance of our findings," Dr. Daniel J. Schwartz said, "is that 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."

People with obstructive sleep apnea are often depressed, Schwartz and Dr. Gillian Karatinos of The Sleep Center at University Community Hospital, Tampa, note in their report.

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 possible," Schwartz told Reuters Health, "that at least some patients being treated with antidepressant medications -- those whose symptoms are due to obstructive sleep apnea -- might be better served with CPAP therapy."

The investigators say it remains "incompletely understood" how CPAP therapy lessens depressive symptoms.

SOURCE: Journal of Clinical Sleep Medicine, October 15, 2007.