The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview.
OBJECTIVE
The aims of this study were: (1) to use a standardized psychiatric interview, conducted by a trained psychologist to assess the prevalence of depression among patients with untreated OSA, and (2) to identify if OSA severity or other comorbid disorders (insomnia, hypertension, and diabetes) are related to depression among patients with untreated OSA.


METHODS
Participants were newly diagnosed patients with OSA (n = 284) waiting to start positive airway pressure (PAP) treatment. The Mini International Neuropsychiatric Interview (MINI) was used to assess depression.


RESULTS
Overall, 15.5% of the sample met the diagnosis for dysthymia. Women had a significantly higher prevalence (29.5% versus 11.7% among men, p < 0.001). The prevalence of major depression was 6% in the overall sample and there was no difference in the prevalence among sexes (5.8% among men versus 6.6 % among women). Obesity, daytime sleepiness, low physical activity, initial and late insomnia, low quality of life, and sleep medication and antidepressant use were all related to depression, whereas OSA severity, as measured by apnea-hypopnea index or oxygen desaturation index, was not. Daytime sleepiness, initial insomnia, and sleep medication use were the strongest predictors of depression in multivariable analyses.


CONCLUSIONS
Sleep medication use, daytime sleepiness, and symptoms of initial insomnia were independently related to depression but OSA severity was not. Increased awareness of the relationship between depression and OSA and the appropriate use of assessment tools might substantially improve diagnostic accuracy as well as treatment outcome for both disorders.
Faculty of Medicine, University of Iceland.|Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
Erla
E
Björnsdóttir
Faculty of Medicine, University of Iceland.|Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
Bryndís
B
Benediktsdóttir
Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine/Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Allan I
AI
Pack
Faculty of Medicine, University of Iceland.|Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
Erna Sif
ES
Arnardottir
Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine/Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.|Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.
Samuel T
ST
Kuna
Faculty of Medicine, University of Iceland.|Department of Respiratory Medicine and Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
Thorarinn
T
Gíslason
Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine/Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Brendan T
BT
Keenan
Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine/Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Greg
G
Maislin
Faculty of Medicine, University of Iceland.|Mental Health Services, Landspítali - The National University Hospital of Iceland, Reykjavik, Iceland.|Reykjavik University, Reykjavik, Iceland.
Jón Fridrik
JF
Sigurdsson
D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000523:psychology
depression; obstructive sleep apnea; psychiatric interview