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Can sleep apnea cause depression?

November 18, 2011

I have a friend named Jean (real name withheld), who has been struggling with depression for a while. It has impacted her life in a hugely negative way, and medications have barely scratched the surface in terms of helping. In fact, at times, they have seemed to make things worse. However, because all of her symptoms fit perfectly with the diagnosis of clinical depression, the psychologists and psychiatrists she has seen have never thought about what else could be causing her to feel this way.

Based on a recommendation from a family member who felt that sleep apnea could be the root of Jean’s health problems (in spite of Jean believing that she has always slept fine), Jean recently went in for a sleep study, and she has now indeed been diagnosed with sleep apnea. It is impossible to know at this time whether or not sleep apnea is the sole cause of her depression, but hopefully during the next few weeks and months, she will find out the answer to this question – ideally by noticing a marked improvement in how she feels when her sleep apnea is treated. I am hopeful that this will be the case, as when you look, there are many stories online (such as this one) from people who have struggled with depression, been diagnosed with and treated for sleep apnea, and their depression has subsequently gone away. So, is there research to support this?

At this point, as far as I am aware (I will be doing more research on this topic), links between sleep apnea and depression come from personal stories, such as the one above, and preliminary research rather than research which has been replicated reliably. However, because I am fascinated by all things related to sleep and all things related to depression, I have been very interested to learn about the potential – although not necessarily 100% proven – link between these two very common health problems (see this article for a dense but an in-depth review of research on this topic) . Please note that I am not suggesting that sleep apnea is the cause of all, or by any means, even most, depression. However, if there is any chance that sleep apnea is the cause of depression for even a small percentage of people, I believe it is worth highlighting, particularly given that sleep apnea is relatively common and very often left undiagnosed. Sleep apnea is also relatively easy to treat. The most effective treatment in most cases is for the person with sleep apnea to use a machine which sits next to the bed and delivers pressurised air to them through a mask which the person wears when they sleep. Although wearing a mask to sleep is certainly an inconvenience, this treatment seems far more straightforward than the treatment for depression, considering the challenges involved in getting the correct mix of medications at the correct dosages, and the time and cost of therapy, not to mention finding a therapist who is effective for a given person. (Please note: I am a firm believer in the benefits of medication and therapy for depression – I simply believe that if there is a different underlying medical cause, such as sleep apnea, which requires another course of treatment, then this is at least equally important to understand, and it may be far easier to treat). Above all else, given the devastating impact depression can have on people’s lives, if sleep apnea is the root cause of depression for even one person, then it is worth writing about!

For more information about sleep apnea, check out:

American Sleep Apnea Association (lots of links here to check out symptoms, causes, diagnosis, etc.)

Sleep Apnoea – NHS Choices (also lots of links here to check out symptoms, causes, diagnosis, etc.)

For research related to the potential links between sleep apnea and depression, check out:

Depression and Obstructive Sleep Apnea  – This is a very interesting open access (meaning everyone can view it) review article. It highlights some research which has  shown a potential link between depression and sleep apnea and it also highlights some research which has not confirmed this link. However, because it is an academic article, it is quite dense, and it is slightly confusing because there is evidence both for and against a link between these two health problems.

BBC News article on depression and sleep apnea – A much more readable news article which highlights a particular study that shows at least a potential link between depression and sleep apnea.

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