Correlation between obstructive sleep apnea and depression, anxiety, affective temperaments and lifestyle factors

Gergely Marton Torzsa, Dalma Csatlós, Csenge Hargittay, Laura Dalnoki, Ajandek Eory, Peter Torzsa

Keywords: Correlation between obstructive sleep apnea and depression, anxiety, affective temperaments, lifestyle factors

Background:

Obstructive Sleep Apnea (OSA) is the most common sleep breathing disorder with a prevalence of 2-4% in the general population which continues to increase in parallel with obesity. OSA is an independent cardiovascular risk factor, in this group hypertension is twice as frequent, myocardial infarction is three times, the risk of diabetes is five times and the danger of traffic accidents while falling asleep is 5-8 times higher than in the general population.

Research questions:

The aim of our study is to assess the prevalence of mood disorders among people with sleep apnea. Our goal was to explore the relationship between affective temperaments and depressive symptoms.

Method:

Sociodemographic and anthropometric data of the patients were recorded, mood disorders were assessed with the Beck Depression Questionnaire (BDI) and the HADS-A self-administered anxiety questionnaire. Affective temperament was examined with the self-reported TEMPS-A questionnaire, while patients' quality of life was assessed with the Promis-57 questionnaire. OSA diagnosis was established with a polysomnography.

Results:

362 patients were included in the study, the average age was 54.2±12.1 (±SD) years, 64.6% were men. The rate of OSA was 33.6% in men and 22.5% in women (p˂0.000). Significantly more patients with OSA exercised (41.1% vs. 28.9%, p=0.023), other lifestyle factors did not reveal any significant difference between the two groups. The prevalence of depressive symptoms among OSA patients was 42%, while among those without sleep disorders it was 14% (p<0.001). In multivariable logistic regression models, the increase in the irritable, depressive and cyclothymic temperament scores showed a close relationship with the increase in BDI score (p<0.001).

Conclusions:

Untreated depression is very common among OSA patients, which worsens the severity of the sleep disorder. Among OSA patients with irritable, depressive or cyclothymic temperaments, severe depressive symptoms were found even more often. Therefore, screening for mood disorders is particularly important in this population.

Points for discussion:

How can we effectively screen for OSA in family practice?

How can we identify the OSA patienst with mood disorders?