Depression and obstructive sleep apnea in patients with coronary heart disease.
OBJECTIVE
Depression is a risk factor for cardiac events in patients with coronary heart disease (CHD). Obstructive sleep apnea/hypopnea syndrome (OSAHS) is frequently comorbid with depression and is also a risk factor for cardiac events. Undetected OSAHS could help explain the increased risk associated with depression.


METHODS
Medically stable patients with CHD and major (MD, n = 53), minor (md, n = 36), or no depression (ND, n = 43) were evaluated for 2 nights in a sleep medicine laboratory.


RESULTS
The prevalence of OSAHS did not differ across groups (MD 66%, md 69%, ND 77%; p > .05). Patients with MD had a significantly greater frequency of apneic episodes, a significantly longer duration of apneas and hyponeas, and more oxygen desaturations per hour than those with md, but there were no differences between MD and ND in frequency of apneic episodes or oxygen desaturations. However, males with MD tended to have more obstructive episodes per hour than did ND males, whereas females with MD had fewer episodes than did ND females. Apnea duration was longer in patients with MD compared with patients with no ND. There was no difference in the mean duration of apnea per hour between the md and ND groups.


CONCLUSIONS
Although OSAHS is not more common in depressed patients with CHD, MD is associated with longer obstructive sleep apneic episodes in both men and women and with a higher frequency of episodes in men.
Carney
Robert M
RM
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA. carneyr@bmc.wustl.edu
Howells
William B
WB
Freedland
Kenneth E
KE
Duntley
Stephen P
SP
Stein
Phyllis K
PK
Rich
Michael W
MW
Miller
Gregory E
GE
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003327:Coronary Disease / Q000209:etiology*; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*