Improved depressive symptoms, and emotional regulation and reactivity, in individuals with obstructive sleep apnea after short- and long-term CPAP therapy use

Emily Pattison; Julie Tolson; Maree Barnes; William J Saunders; Delwyn Bartlett; Luke A Downey; Melinda L Jackson

doi:10.1016/j.sleep.2023.08.024

Improved depressive symptoms, and emotional regulation and reactivity, in individuals with obstructive sleep apnea after short- and long-term CPAP therapy use

Sleep Med. 2023 Nov:111:13-20. doi: 10.1016/j.sleep.2023.08.024. Epub 2023 Sep 1.

Authors

Emily Pattison¹, Julie Tolson², Maree Barnes³, William J Saunders⁴, Delwyn Bartlett⁵, Luke A Downey⁶, Melinda L Jackson⁷

Affiliations

¹ Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Australia; RMIT University, School of Health and Biomedical Science, Melbourne, Australia.
² Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Australia.
³ Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Australia; The University of Melbourne, Melbourne, Australia.
⁴ Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
⁵ Woolcock Institute for Medical Research, & the University of Sydney, NSW, Australia.
⁶ Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Australia; Centre for Human Psychopharmacology, Swinburne University, Hawthorn, Melbourne, Australia.
⁷ Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Australia; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia. Electronic address: melinda.jackson@monash.edu.

PMID: 37714031
DOI: 10.1016/j.sleep.2023.08.024

Abstract

Obstructive Sleep Apnoea (OSA) is associated with high rates of depression; however, if and how treatment of OSA improves depressive symptoms is unclear. To further understand this link we considered the role of emotional regulation - the ability to control and express our emotional responses - thought to be a central component of depression. This study aimed to assess changes in depressive symptoms and emotional responses in individuals with OSA after 4- and 12-months of continuous positive airway pressure (CPAP) treatment. One-hundred and twenty-one OSA participants (50 female, M_age = 51.93; mean AHI = 36.27) were recruited from a tertiary clinical sleep service prior to CPAP initiation, and randomised to either a CPAP group or a 4 month wait-list group. Participants completed the Center for Epidemiological Studies Depression Scale, the Emotional Reactivity Scale and the Difficulties in Emotion Regulation Scale at baseline, and 1-, 2-, and 4-months follow-up. The CPAP group also completed the questionnaires 12-months after CPAP initiation. CPAP use at 1 month and 12 months was 5.1h/night and 4.9h/night, respectively. Significant improvements in depressive symptoms, emotional regulation and reactivity, and subjective sleepiness were observed after 4 months in both groups, however, the within group changes were only significant for those using CPAP. After 12-months of CPAP treatment, these improvements were maintained. There was no association between CPAP treatment adherence and improvements in any outcome. CPAP treatment for 12 months may reduce symptoms of depression and improve emotional regulation in individuals with OSA.

Keywords: Continuous positive airway pressure; Depression; Emotion; Sleep; Sleepiness.