Sleep apnea and depression

Sleepiness, fatigue, difficulty concentrating and irritability - these symptoms really could be part of the description of many disorders. They are common in depression and also happen to be hallmarks in a sleep disorder called sleep apnea.

Not only do they share some symptoms, but sleep apnea and depression also frequently co-exist and doctors diagnosing and treating depression should screen for the common sleep disorder.

Obstructive sleep apnea is (OSA) the most common form of this condition and occurs when soft tissue at the back of the throat relaxes during sleep and blocks the airway. Individuals with OSA repeatedly stop breathing during sleep for between 10 and 30 seconds at a time. This can happen many times throughout the night and results in disrupted sleep patterns and many physical consequences as a result of the disturbed sleep.

Most of the time, people experiencing sleep apnea are not aware of their condition unless it is observed by someone else. Although they may not realize it, the interrupted nights are resulting in daytime impairment of functioning and also increasing the likelihood of heart disease, stroke and premature death.

Between 30 and 50 percent of individuals with OSA also experience depression. For this reason, it is likely that every psychiatrist already sees several patients with this potentially dangerous condition.

Depression related fatigue is difficult to distinguish from the excessive daytime sleepiness of OSA, but it can be done by asking the right questions or performing a sleep study to rule out sleep apnea.

Aside from daytime sleepiness, a few other hallmark symptoms in OSA include chronic loud snoring, gasping or choking during sleep, frequent morning headaches, waking up with a dry mouth or throat, restless or fitful sleep or frequent night waking.

Often, when proper sleep is restored, mood and cognition improve dramatically – which could make co-existing depression easier to treat.

Although sleep apnea can occur in anyone at any age, it is associated with obesity and is also more common in men than women. It is estimated that roughly four percent of men experience sleep apnea and two percent of women.

For individuals experiencing both depression and OSA, antidepressant use may aggravate OSA as some of these medications can cause sleepiness or prompt weight gain, which can worsen symptoms in OSA. The Journal of Clinical Psychiatry published one study suggesting a non-amphetamine wakefulness-promoting medication called armodafinil could reduce sleepiness in patients experiencing OSA and depression.

Treatment for sleep apnea often involves sleeping with a Continuous Positive Airflow Pressure (CPAP) machine. The CPAP machine is a mask-like machine providing a constant stream of air to keep your airways open while you sleep. In many cases, patients experience immediate symptom relief when using the CPAP.

If you are receiving treatment for depression and feel you may also have sleep apnea, speak with your doctor. It is possible to restore good sleep and that will undoubtedly make a big difference in your life.

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About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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