Severe obstructive sleep apnea (OSA) and excessive daytime sleepiness are associated with an increased risk of depression in men, according to a new community-based study of Australian men, which was presented at the 2015 American Thoracic Society International Conference.
"An association between sleep apnea and depression has been noted in some earlier studies," said lead author Carol Lang, PhD, from the University of Adelaide, Australia. "Our study, in a large community-based sample of men, confirms a strong relationship even after adjustment for a number of other potential risk factors."
The study involved 1875 men aged between the ages of 35 and 83 who were assessed for depression at two time points over a 5-year period. A random sample of 857 men without previously diagnosed OSA underwent at home polysomnography and completed the Epworth Sleepiness Scale questionnaire.
After adjustment for potential confounders, previously undiagnosed severe OSA was associated with an increased prevalence of depression (adjusted odds ratio [OR] 2.1, 95% CI 1.1-4.0), as was excessive daytime sleepiness (adjusted OR 1.1, 95% CI 1.0-1.2). Men who had both previously undiagnosed OSA (either mild to moderate or severe OSA) and excessive daytime sleepiness had 4 to 5 times greater odds of having depression than men without either condition.
Both previously diagnosed OSA (OR 2.0, 95% CI 1.15-3.45) and previously undiagnosed severe OSA (OR 2.9, 95% CI 1.19-6.92) were significantly associated with recent development of depression.
"Excessive daytime sleepiness and severe OSA were both associated with the prevalence and recent onset of depression in our community-based sample of men, and the presence of both was associated with an even greater risk," said Dr. Lang. "Men presenting with depression should be screened for OSA, so that an appropriate course of treatment can be planned."