Profile of depressive symptoms in sleep apnea- gender differences and the role of obesit

Abstract

Objective: The objective was to evaluate depressive symptoms, sleep alterations and the role of gender and obesity in obstructive sleep apnea (OSA) patients. Methods: Patients (N=140; 92 males and 48 female; age 54.6±8.2 years), submitted to polysomnography for suspected OSA, were assessed by the 17-item Hamilton Rating Scale for Depression (HRSD), Charlson comorbidity index (CCI) and Epworth Sleepiness Scale (ESS). All patients were divided in two groups: snorers/mild OSA group (apnea hypopnea index (AHI) ≤15, N=54) and moderate/severe OSA group (AHI>15, N=86). Results: The most affected components of the HDRS in both genders were anxiety, somatic and psychological, followed by work and activities complaints and depressed mood. Late insomnia predominated over early and middle night insomnia. Snorers/mild OSA women showed higher HDRS scores (p=0.002). Obese patients showed higher HDRS scores vs non-obese (BMI>30, N=96) (8.52±5.0 vs 6.38±5.0, p=0.02). The profile of depressive symptoms was similar for obese vs non-obese. Excessive daytime sleepiness (ESS>10) was present in 57 cases (40.7%). ESS scores were negatively correlated with minimum SpO2 values (r=-0.18, p=0.03) and positively correlated with arousal frequency (r=0.24, p=0.02). Sedatives (12.1%) or antidepressants (5.7%) were seldom used. Conclusion: Depressive symptoms in OSA, in both genders, are characterized by somatic and psychological anxiety, work complaints, depressed mood and late insomnia; obese patients are more affected.