CPAP Therapy improves Depressive Symptoms in OSA Patients, including those using Antidepressant Medication

Abstract

Continuous positive airway pressure (CPAP) has consistently improved depressive symptoms of Obstructive Sleep Apnoea (OSA) patients. Yet, only one study included OSA patients using antidepressants. We assessed the effects of CPAP on depressive symptoms in OSA patients, including those using antidepressants. Also, evaluating if antidepressant users differ in presentation to sleep clinics or response to CPAP. At initial sleep consultations, 101 participants completed the Public Health Questionnaire-9 (PHQ 9) to assess depressive symptoms. Also, the Epworth Sleepiness Scale, Fatigue Severity Scale, and Massachusetts General Hospital Antidepressant Treatment Resistance Questionnaire to define antidepressant treatment. 96 participants completed a diagnostic sleep study, with severity assessed by Apnoea-Hypopnoea Index (AHI). 43 were diagnosed with OSA and began CPAP treatment. After 6-8 weeks of CPAP, 30 repeated the questionnaires. 58.4% of all participants and 60.5% of those with OSA had significant depressive symptoms. The 32.7% using antidepressants were significantly more depressed (p The highly prevalent depressive symptoms in OSA patients improve significantly with CPAP therapy, even after resistance to antidepressant medication. The reduction in OSA severity from antidepressants may prevent these patients being treated with CPAP and achieving an improvement in depressive symptoms.