Continuous positive airway pressure improves symptoms of depression in obstructive sleep apnea patients

Patients with obstructive sleep apnea (OSA) who also suffer from depression often find that continued use of continuous positive airway pressure (CPAP) relieves them of symptoms of depression, according to a study published in the October 15 issue of the Journal of Clinical Sleep Medicine (JCSM).

Daniel J. Schwartz, MD, of The Sleep Center at University's Community Hospital in Tampa, Fla., surveyed patients referred to his sleep center for evaluation of OSA and who demonstrated a significant response to CPAP. The subjects were evaluated for symptoms of depression, were assessed again after four to six weeks of treatment with CPAP and then reassessed approximately one year later.

In this group of patients, the institution of CPAP therapy resulted in a significant decrease in those symptoms of depression that were assessed at both the short-term and long-term follow-up periods.

“Why the use of CPAP is associated with the changes in these symptoms is incompletely understood. Whether relief of the obstructive respiratory events with CPAP might ameliorate the symptoms by improving sleep continuity, by ameliorating the adverse effects of various neurotransmitters, by alleviating the adverse effects of any attendant hypoxemia, or by a mechanism as yet unknown, cannot be determined on the basis of the findings of our study. But, the data from our study suggests that successful CPAP therapy is associated with a statistically significant improvement in symptoms of depression, and that the improvement is sustained long term,” said Dr. Schwartz.

First introduced as a treatment option for sleep apnea in 1981, CPAP is the most common and effective treatment for OSA. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.

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