The relationship between depressive symptoms and obstructive sleep apnea in pediatric populations: a meta-analysis.
BACKGROUND
A higher incidence of depressive disorders and symptoms has been suggested among children suffering from obstructive sleep apnea (OSA). Yet, the extent to which OSA is related to increased depression is unclear.


OBJECTIVE
To evaluate (a) the relationship between depressive symptoms and OSA in pediatric populations, and (b) the efficacy of adenotonsillectomy (AT) for decreasing depressive symptoms among children with OSA.


METHODS
A meta-analysis was conducted to assess the relationship between depressive symptoms and OSA, and the efficacy of AT for decreasing depressive symptoms. Studies reporting depressive symptoms of children with OSA through January 2013 were included.


RESULTS
Eleven studies assessed depressive symptoms in both children diagnosed with OSA (n = 894) and a comparison group (n = 1,096). A medium relationship was found between depressive symptoms and OSA (Hedges' g = 0.43, 95% CI: 0.22-0.64; p = 0.0005). Addressing the second question, 9 studies (n = 379 children) examined depressive symptoms pre- and post-AT. A medium improvement in depressive symptoms was found at follow-up (Hedge's g = 0.41, 95% CI: 0.20-0.62; p ≤ 0.001).


CONCLUSIONS
Our findings suggest that depressive symptoms are higher among children with OSA. Therefore, patients with depressive symptomatology should receive screening for sleep disordered breathing. Treatment of OSA with AT might decrease clinical symptoms of depression, reduce pharmacotherapy, improve sleep patterns, and promote better health.
Department of Child and Adolescent Psychiatry, Drexel University College of Medicine, Philadelphia, PA.
Elif
E
Yilmaz
Karim
K
Sedky
David S
DS
Bennett
D000233:Adenoidectomy / Q000379:methods; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000150:complications*; D006801:Humans; D010372:Pediatrics / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000601:surgery; D014068:Tonsillectomy / Q000379:methods
Sleep disordered breathing; depression; depressive symptoms; meta-analysis; obstructive sleep apnea