Sleep apnea increases risk for depression, anxiety: JAMA Study

Korea: Patients with obstructive sleep apnea (OSA) are at increased risk for mood disorders -- depression and anxiety, a recent study published in the journal JAMA Otolaryngology-Head & Neck Surgery has found.

Mayo Clinic defines obstructive sleep apnea as a potentially serious sleep disorder. It is characterized by repeated cessation of breathing during sleep. It occurs when throat muscles intermittently relax and block the airway during sleep. A noticeable sign of obstructive sleep apnea is snoring.

Numerous studies have associated OSA with exacerbation of several health conditions including hypertension, cardiovascular disease, stroke, and type 2 diabetes. However, the association between OSA and the psychological health of affected individuals has not been fully evaluated.

Jong-Yeup Kim, College of Medicine, Konyang University, Daejeon, Republic of Korea, and colleagues investigated the association between OSA and development of affective disorders.

The study used a nationwide representative cohort sample from the Korea National Health Insurance Service–National Sample Cohort database comprising data from 1 025 340 patients. The researchers included 197 patients with OSA diagnosed between 2004 and 2006 and 788 people without the condition matched for age, sex, and socioeconomic and health characteristics. Data were analyzed from September 28, 2018, to March 30, 2019.

Key findings include:

• Of the total population of 985 (860 male [87.3%], 540 [54.8%] were aged <45 years), the incidences per 1000 person-years of affective disorders were 49.57 and 27.18 in the OSA and comparison groups, respectively.


• A total of 1371.7 person-years in the OSA group and 6328.6 person-years in the comparison group were evaluated for affective disorder events.


• After adjustment for sociodemographic factors (age, residential area, and household income), disability, and comorbidities, the adjusted HRs for patients with OSA developing affective disorders in patients with OSA during the 9-year follow-up period was 2.04.


• In a subgroup analysis, the adjusted HRs for patients with OSA who developed depressive and anxiety disorders were 2.90 and 1.75 respectively.


• Female patients with OSA had a significant likelihood of prospective development of depression and anxiety (adjusted HR for depression, 3.97; adjusted HR for anxiety, 2.42) compared with male patients with OSA (adjusted HR for depression, 2.74; adjusted HR for anxiety, 1.64).

"Further studies appear to be needed to confirm our findings and, if validated, then studies are needed to explore the nature of the observed association, including potential causality, between OSA and affective symptoms," concluded the authors.

More Information: "Association of Obstructive Sleep Apnea With the Risk of Affective Disorders" published in the journal JAMA Otolaryngology-Head & Neck Surgery.

DOI: 10.1001/jamaoto.2019.2435

Journal Information: JAMA Otolaryngology-Head & Neck Surgery