CPAP May Improve Depression In Patients With Sleep Apnea

Dr. Marcus Povitz MD Department of Community Health Sciences University of Calgary, Calgary, Alberta, Canada Adjunct Professor and Clinical Fellow Western University Department of Medicine, Western University, London, Ontario, CanadaMedicalResearch.com Interview with:
Dr. Marcus Povitz MD
Department of Community Health Sciences
University of Calgary, Calgary, Alberta, Canada
Adjunct Professor and Clinical Fellow
Western University Department of Medicine,
Western University, London, Ontario, Canada

Medical Research: What is the background for this study? What are the main findings?

Dr. Povitz: Both depression and obstructive sleep apnea are important causes of illness and have overlapping symptoms. Both feature poor quality sleep, difficulty with concentration and memory as well as daytime sleepiness or fatigue. Previous research showed that depression is common in individuals with sleep apnea, but studies investigating the effect of treating sleep apnea on depressive symptoms have had conflicting results. Our study combined the results of all randomized controlled trials of participants who were treated for sleep apnea with CPAP or mandibular advancement devices where symptoms of depression were measured both before and after treatment. We found that in studies of individuals without a lot of symptoms of depression there was still a small improvement in these symptoms after treatment with CPAP or mandibular advancement device. In 2 studies of individuals with more symptoms of depression there was a large improvement in symptoms of depression.


Medical Research: What should clinicians and patients take away from your report?

Dr. Povitz: Our findings indicate that treatment with CPAP or mandibular advancement devices can lead to modest improvements in depressive symptoms among people with obstructive sleep apnea. However, it is important for clinicians to realize that the studies we identified did not address the efficacy of CPAP and mandibular advancement devices compared to standard treatments for depression such as anti-depressant medications.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Povitz: Within in our systematic review we did not find any studies that compared treatment of OSA versus standard therapies for depression or that used clinical interviews to confirm a diagnosis of depression (the gold standard). We would like to see studies that address these limitations. Ideally, the next steps would involve a randomized controlled trial evaluating potential benefits of CPAP in patients with OSA who also have depression.

Citation:
Effect of Treatment of Obstructive Sleep Apnea on Depressive Symptoms:
Systematic Review and Meta-Analysis

Marcus Povitz equal contributor, Carmelle E. Bolo equal contributor, Steven J. Heitman, Willis H. Tsai, JianLi Wang, Matthew T. James Published: November 25, 2014
DOI: 10.1371/journal.pmed.1001762