Abstract
Obstructive sleep apnea (OSA) is a common sleep disorder occurring across all age groups, gender, and is multifactorial. The episodic decrease in airflow during sleep results in hypoxia and hypercapnia over time, resulting in morning headache, systemic and pulmonary hypertension, and polycythemia. Fragmentation of sleep at night-time cause daytime somnolence, fatigue, memory problems, and mood symptoms such as depression and anxiety. These secondary mood symptoms could be easily missed by healthcare providers as the primary disorder resulting in unnecessary anti-depressants' prescription. This study investigates the effect of continuous airway pressure (CPAP) on depressive symptoms of OSA. We used PubMed, PubMed Central (PMC), and MEDLINE for data collection. We used OSA, depression, anxiety, mood symptoms, psychological symptoms, and CPAP as the keywords, both alone and in combination. The search ended on November 5, 2020, and it was limited to the year 2010 until the day of the search. However, a few of the papers published earlier than 2010 were also included to have better insight into some aspects of the topic. We included articles measuring the impact of CPAP on mood symptoms using any one of the validated scales, such as the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS), or Hamilton Depression Scale (HAM-D). Our initial searches yielded 131 articles. Twenty-one of the 131 papers satisfied the review's criteria. Four studies out of 21 revealed no improvement in OSA-related mood symptoms with CPAP therapy, whereas the others reported beneficial effects on mood, daytime sleepiness, cognition, and patient quality of life.
Highlights
BackgroundGlobally, about one billion people between the ages of 30 years and 69 years, either symptomatic or asymptomatic, are estimated to diagnose with obstructive sleep apnea (OSA) based on the apnea/hypopnea index (AHI) [1]
This review aimed to investigate whether CPAP therapy improves depression in patients with OSA so that people with mood symptoms of OSA are treated with CPAP before they are wrongly prescribed anti-depressants
We reviewed published literature to determine CPAP's impact on mood symptoms in patients with OSA
Summary
About one billion people between the ages of 30 years and 69 years, either symptomatic or asymptomatic, are estimated to diagnose with obstructive sleep apnea (OSA) based on the apnea/hypopnea index (AHI) [1]. Csábi et al conducted a clinical trial of 24 recently diagnosed and untreated patients who underwent CPAP therapy for two and a half months They concluded that CPAP helps restore normal sleeping patterns by improving breathing during sleep, reducing sleepiness's subjective sensation [18]. The above-mentioned studies had a small sample size that was overcome by Bhat et al, who observed 182 respondents They found a rather interesting finding in their research, that while there was an improvement in the subjective symptoms of daytime sleepiness, exhaustion, and depression in both mild and severe form of OSA, objective vigilance was found to be improved only in severe OSA as assessed by the psychomotor vigilance task (PVT) [19]. CPAP treatment did not show a specific therapeutic effect on mood symptoms in patients with OSA
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