Is there a connection between sleep apnea & depression?


It is sometimes more difficult to see is the connection between sleep apnea and mental processes such as mood changes, cognitive function and depression, and the impact this can have on the person with this untreated sleep disorder.

There are innumerable clear and measurable side effects that result from untreated sleep apnea, from Excessive Daytime Sleepiness (EDS) to high blood pressure.

Hypersomnia and depressive symptoms: methodological and clinical aspects

Are sleep apnea and depression linked?

On its own, depression cannot cause obstructive sleep apnea, per se. There is no doubt however that untreated sleep apnea can trigger depression. This triggering is caused by disruption of the natural sleep cycle that sleep apnea causes. This disruption of sleep is called “sleep fragmentation”.

Quality or ‘restorative’ sleep is necessary for health

Sleep is vital to maintaining your mental and physical health. Adults need an average of 8 hours of uninterrupted sleep. This means sleep which allows a normal cycling of the sleep stages. There are considered to be three non-rem (NREM) sleep stages. REM sleep is believed important for daytime function as well as many sleep related activities.

Depression and Obstructive Sleep Apnea (OSA)

How does sleep apnea affect depression?

Untreated sleep apnea wakes you up multiple times a night due to sleep apnea episodes where your airway will become obstructed. Many times, these awakenings are below the threshold of consciousness so you often don’t remember awakening.

This continual disruption or sleep stage fragmentation keeps your brain from going through the restorative cycle it needs to maintain your moods during the day by interrupting the normal cyclical rhythm.

People generally experience around 5 sleep cycles par night. This can be reduced or even eliminated in sleep disorders – and the experience of REM also affected.

Sleep apnea treatment can assist with depression

Studies have shown that sleep apnea and depression are linked. A recent study has shown that sleep apnea treatment can have a significant impact on depression.

Participants in the study who had clinical depression and sleep apnea were asked to stick to a regular regiment of using a CPAP machine. (The mask/hose/pump assembly – Continuous positive airway pressure.) By the three-month follow up on the participants, all of them—even those with previously suicidal thoughts—reported feeling significantly better.

CPAP therapy reduces symptoms of depression in adults with sleep apnea

Can depression mask obstructive sleep apnea

Yes – it is important to point out that depression can actually mask that you have obstructive sleep apnea. Many of the side effects of depression such as constant fatigue, oversleeping, sexual dysfunction, and other issues overlap with sleep apnea and could keep you from being properly diagnosed. 

With the present COVID-19 pandemic, quality sleep and the fight against depression are very real. The need for help becomes increasingly important despite clinical help being limited Rest assured there are solutions even now.

Are there alternatives to CPAP?

Oral appliances for obstructive sleep apnoea

Yes there are. There are two main ways of managing obstructive sleep apnea(OSA) and snoring as well as several lifestyle changes which can help. The main choices are CPAP and an oral appliance to prevent to lower jaw from falling back and obstructing the airway. All options should be discussed in full before a decision is made. This is called, “informed consent” and while a legal requirement may not be fulfilled due to lack of knowledge or commercial bias.

If you feel concerned about this drop us a line. Snoring is associated with poor sleep, suffered both by the snorer and the bed partner.

Rest assured there are solutions even now.

Dr. Stephen Bray 2020

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