This study examined the prevalence of depression and anxiety symptoms in OSA patients, and predictors of mood disturbance in male and female patients. N = 344 consecutive OSA patients (mean age 51.6 SD 14.1 years, 176 women) completed the Epworth Sleepiness Scale and the Hospital Anxiety and Depression Scale. 42.3% of females reported significant depressive symptoms compared to 32.7% of males, and 29.7% of females compared to 21.4% of males reported significant anxiety. In women, sleepiness, anxiety, and BMI were significant predictors of depression, whereas only sleepiness and anxiety were significant predictors of depression in males. Obesity was a stronger predictor of depression among women, suggesting a complex interaction between weight, sleep, and depression in female patients.
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The authors would like to thank the Sleep Laboratory staff for their assistance with data collection. MLJ was supported by a National Health and Medical Research Council (NHMRC) of Australia Fellowship (APP1036292).
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Conflict of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Jackson ML, Howard ME, Barnes M. Cognition and daytime functioning in sleep-related breathing disorders. In: Van Dongen H, Kerkhof G, editors. Progress in brain research. vol. 190. Netherlands: Elsevier B.V.; 2011. p. 53–68.Google Scholar
Aloia MS, Arnedt JT, Smith L, Skrekas J, Stanchina M, Millman RP. Examining the construct of depression in obstructive sleep apnea syndrome. Sleep Med. 2005;6(2):115.CrossRefGoogle Scholar
Saunamäki T, Jehkonen M. Depression and anxiety in obstructive sleep apnea syndrome: a review. Acta Neurol Scand. 2007;116(5):277–88.CrossRefGoogle Scholar
Lee S-A, Han S-H, Ryu HU. Anxiety and its relationship to quality of life independent of depression in patients with obstructive sleep apnea. J Psychosom Res. 2015;79(1):32–6.CrossRefGoogle Scholar
Sforza E, Saint Martin M, Barthélémy JC, Roche F. Mood disorders in healthy elderly with obstructive sleep apnea: a gender effect. Sleep Med. 2016;19:57–62.CrossRefGoogle Scholar
Björnsdóttir E, Benediktsdóttir B, Pack AI, Arnardottir ES, Kuna ST, Gíslason T, et al. The prevalence of depression among untreated obstructive sleep apnea patients using a standardized psychiatric interview. J Clin Sleep Med. 2016;12(1):105–12.CrossRefGoogle Scholar
Wahner-Roedler DL, Olson EJ, Narayanan S, Sood R, Hanson AC, Loehrer LL, et al. Gender-specific differences in a patient population with obstructive sleep apnea-hypopnea syndrome. Gender Med. 2007;4(4):329–38.CrossRefGoogle Scholar
Bjorvatn B, Rajakulendren N, Lehmann S, Pallesen S. Increased severity of obstructive sleep apnea is associated with less anxiety and depression. J Sleep Res. 2018;29(6):e12647.CrossRefGoogle Scholar
Dixon JB, Dixon ME, O’Brien PE. Depression in association with severe obesity: changes with weight loss. Arch Intern Med. 2003;163(17):2058–65.CrossRefGoogle Scholar
Asghari A, Mohammadi F, Kamrava SK, Tavakoli S, Farhadi M. Severity of depression and anxiety in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2012;269(12):2549–53.CrossRefGoogle Scholar
Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep. 1991;14(6):540–5.CrossRefGoogle Scholar
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRefGoogle Scholar
Law M, Naughton MT, Dhar A, Barton D, Dabscheck E. Validation of two depression screening instruments in a sleep disorders clinic. J Clin Sleep Med. 2014;10(6):683–8.PubMedPubMedCentralGoogle Scholar
Shahar E, Redline S, Young T, Boland LL, Baldwin CM, Nieto FJ, et al. Hormone replacement therapy and sleep-disordered breathing. Am J Respir Crit Care Med. 2003;167(9):1186–92.CrossRefGoogle Scholar