Simultaneous use of antidepressant and antihypertensive medications increases likelihood of diagnosis of obstructive sleep apnea syndrome.
BACKGROUND
Essential hypertension and symptoms of depression such as unexplained fatigue and tiredness are frequently encountered in primary medical care clinics. Although, exhaustive evaluation rarely detects unsuspected underlying disorders, obstructive sleep apnea (OSA) is commonly associated with each of these conditions. We tested the hypothesis that therapy with antihypertensive and antidepressant medications predicts the increased likelihood of OSA.


METHODS
We analyzed the computer archive of 212,972 patients for prescriptions for antihypertensive medications, antidepressant medications, and International Classification of Diseases, Ninth Revision codes for OSA. Prevalence, prevalence odds ratio (POR), and confidence intervals (CIs) were calculated correcting for gender and age group.


RESULTS
The prevalence rates of OSA were 0.8%, 2.8%, and 3.2% for men and 0.4%, 1.4%, and 1.8% for women aged 20 to 39 years, 40 to 59 years, and >or= 60 years, respectively. Compared to groups of corresponding age and gender who had not received prescriptions for either hypertension or depression, the highest PORs were found in patients receiving medications from both categories: 18.30 (95% CI, 10.69 to 25.66), 5.72 (95% CI, 4.10 to 6.70), and 4.47 (95% CI, 2.45 to 7.01) for men, and 17.43 (95% CI, 9.54 to 28.67), 7.29 (95% CI, 5.20 to 9.29), and 2.72 (95% CI, 1.48 to 4.73) for women.


CONCLUSIONS
We found that the likelihood of having a diagnosis of OSA increases when either antihypertensive or antidepressant medications have been prescribed. The probability is highest in the young and middle-age groups receiving prescriptions for both medications. The possibility of OSA should be considered in any patient with hypertension and depression or unexplained fatigue who is receiving antihypertensive and antidepressant medications.
Farney
Robert J
RJ
Intermountain Sleep Disorders Center, LDS Hospital, Salt Lake City, UT 84143, USA. rjfmd@msn.com
Lugo
Alejandra
A
Jensen
Robert L
RL
Walker
James M
JM
Cloward
Tom V
TV
D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D003863:Depression / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination; D015673:Fatigue Syndrome, Chronic / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis*
D000928:Antidepressive Agents; D000959:Antihypertensive Agents