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Objective: Respiratory disorder during sleep is an important public health issue. The majority of these disorders are mainly made up of obstructive sleep apnea syndrome (OSAS). Concentration disorder, loss of memory, depression, psychosis, impotence and decreased libido are the most commonly neuropsychiatric disorders seen with OSAS. Too much sleepiness observed in OSAS patients worsens the life quality of these individuals. The number of studies revealing the rate of depression with applied structured clinical interview for DSM-IV disorders (SCID) in OSAS patients is limited.
Method: This study was carried out in 101 patients with polysomnographic (PSG) records. PSG was done to all participants and all of them were classified according to Apnea-Hipopnea index (AHI). Groups were classified as; Simple Snore (n=20, 15<=AHI<30), mild OSAS (n=27, 5<=AHI<15), moderate OSAS (n=20, 15<=AHI<30), and severe OSAS (n=34, AHI>=30). Simple snore group was accepted as a control group. We investigated mainly the differences between groups. We applied SCID, Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI), Epworth Sleepiness Scale, Pittsburg Sleep Quality Index (PSQI) and SF 36 Life Quality Survey to all participants.
Results: Without discriminating the gender, according to comparison of HAM-D scores, we found that the depression rate was the highest and statistically meaningful among moderate OSAS group. This was followed by severe OSAS group and then mild OSAS group, respectively. Depression rate was the lowest (p=0.015) in Simple Snore group when compared with other apnea groups. No difference was found between groups when EUS, PSQI and BMI scores were compared. We found lower scores of Social Function, subdivision of SF 36 Life Quality Survey, in severe OSAS group versus other groups especially when compared with simple snore. When we assessed other subdivisions of SF 36 Life Quality Survey no difference was found between groups. Subtracting simple snore (control group) from all participants we have OSAS group. We found depression a rate of 67% (n=54) among patients with OSAS (n=81) according to SCID applied HAM-D scores. When neck circumference, EUS and PSQI scores were compared, no difference was found between OSAS patients with and without depression. We found a high BMI among OSAS patients with depression (p<0.05). When we compared SF 36 subdivisions, all subdivision scores were lower in OSAS patients with depression versus OSAS patients without depression (p<0.05).
Conclusion: These results show that depression rate is higher among OSAS patients. OSAS negatively affects the life quality. In our study all 8 subdivisions of life quality scores were lower among OSAS patients with depression, when compared with OSAS patients without depression. This result supports the thesis that life quality was affected more negatively with OSAS and depression comorbidity. The severity of OSAS is not related with decreased quality of life as shown in previous studies. Therefore, mood and depressive state should be assessed carefully in order to improve the quality of life of severe OSAS patients.