Increased Risk Of Depression With Breathing Problems During Sleep

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Increased Risk Of Depression With Breathing Problems During Sleep

http://www.medicalnewstoday.com/medicalnews.php?newsid=52212

Individuals who have sleep-related breathing disorder appear

significantly more likely to develop depression, with odds of

depression increasing as breathing disorders becomes more severe,

according to a study in the September 18 issue of Archives of

Internal Medicine, a theme issue on sleep.

Frequent pauses in breathing, labored breathing or reduced breathing

during the night are hallmark signs of sleep-related breathing

disorder, according to background information in the article. The

disorder has been linked to a variety of negative health

consequences, including cardiovascular disease and difficulty

functioning during the day. Previous studies have suggested that

depression improves when sleep-related breathing disorder is treated,

indicating that these two common conditions are related.

Characterizing the relationship, the authors write, could " guide

screening for depressive symptoms in patient populations with sleep-

related breathing disorder, suggest strategies for managing sleep-

related breathing disorder-related depression and alert clinicians

about the possibility of untreated depression complicating adherence

to sleep-related breathing disorder mitigation strategies and

treatments .... "

E. Peppard, Ph.D., and colleagues at the University of Wisconsin-

Madison evaluated 1,408 adults (788 men, 620 women) who were between

the ages of 30 and 60 at the beginning of the study, in 1988. The

participants stayed overnight in a laboratory once every four years,

during which time sleep was monitored with a test known as

polysomnography and breathing disturbances were recorded. By May

2005, 449 participants had completed one sleep study, 382 completed

two, 319 completed three and 258 completed four, for a total of 3,202

sleep studies. At each sleep study, body mass index was recorded and

interviews and questionnaires completed by participants provided

information about medical history, lifestyle habits, demographics and

whether they had difficulty sleeping at night (insomnia) or felt

sleepy during the day.

During the 3,202 sleep studies, 334 showed no evidence of reduced or

paused breathing. Among cases of sleep-related breathing disorder,

1,911 were categorized as minimal, defined as an average of fewer

than five incidences of reduced or paused breathing per hour; 606

were mild, with an average of five to 14 such events per hour; and

351 were moderate or worse, with 15 or more events per hour. About

twice as many men as women had mild, moderate or worse sleep-related

breathing disorder--14 percent of sleep studies among men revealed

moderate sleep-related breathing disorder, vs. 6 percent of women.

Throughout the study, there were 649 cases of mild depression and 392

of moderate or more severe depression. Women were about twice as

likely to be depressed as men (27 percent vs. 15 percent).

Compared with patients without sleep-related breathing disorder,

those with minimal cases of the condition were 1.6 times as likely to

be depressed; those with mild cases, twice as likely; and those with

moderate or worse, 2.6 times as likely. Individuals whose breathing

problems worsened over time increased their risk for

depression. " Among these studies, an increase in sleep-related

breathing disorder to the next higher category (for instance, from no

sleep-related breathing disorder to minimal sleep-related breathing

disorder) was associated with a 1.8-fold increased odds for

development of depression compared with unchanging sleep-related

breathing disorder, " the authors write. " For example, persons

initially without sleep-related breathing disorder but in whom

minimal sleep-related breathing disorder developed during a four-year

period are estimated to be at 80 percent greater odds for development

of depression than those who remain without sleep-related breathing

disorder. "

" Our longitudinal findings of a dose-response association between

sleep-related breathing disorder and depression provide evidence

consistent with a causal link between these conditions and should

heighten clinical suspicion of depression in those with sleep-related

breathing disorder, " they conclude.

This study was supported by grants from the National Institutes of

Health.