Obstructive sleep apnea (OSA) and clinical depression-prevalence in a sleep center

Sleep Breath. 2017 May;21(2):311-318. doi: 10.1007/s11325-016-1411-3. Epub 2016 Oct 5.

Abstract

Background: This study aimed to determine the prevalence of clinical depression as defined by ICD-10 criteria in all patients with obstructive sleep apnea (OSA) referred to a sleep center.

Methods: Prospective general and sleep evaluations were conducted in 447 consecutive patients referred to our sleep center during the first quarter of 2008. Inclusion criteria were Apnea Hypopnea Index (AHI) > 9, completion of the Beck Depression Inventory (BDI-II) with a score ≥14 and World Health Organization WHO-5 Well-Being Index (WHO-5) ≤ 13. The subsequent psychiatric examination according to ICD-10 criteria was performed by in-house clinical sleep specialists.

Results: A total of 447 patients were surveyed, of whom 322 had an AHI > 9. Out of these, 85 met the combined screening criterion BDI II ≥ 14 and WHO-5 ≤ 13. Eighty-one patients underwent a psychiatric examination by psychiatric sleep specialists. In 21.5 % of the sample, clinical depression was diagnosed. Other complaints existed in 12 % (n = 10); 7 % (n = 6) of patients had a different psychiatric diagnosis.

Conclusions: The prevalence of clinical depression according to ICD-10 criteria in a selected clinical sample (referred to the sleep center) was 21.5 %. Mood scales tend to overestimate complaints as compared to psychiatric consultation. Interdisciplinary cooperation is recommended for both OSA patients with symptoms of depression and depressed patients with treatment resistance.

Keywords: Comorbidity; Depressive disorder; Obstructive sleep apnea; Polysomnography; Sleep disorders.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / epidemiology*
  • Female
  • Germany
  • Humans
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Personality Inventory
  • Polysomnography
  • Prospective Studies
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*
  • Statistics as Topic