Obstructive Sleep Apnea and Depression

Introduction to OSA and Depression

• The American Thoracic Society recognizes that OSA has been linked to depression, with research suggesting a bidirectional relationship 1

Diagnosis and Evaluation

• Use actigraphy to help characterize sleep patterns, as it can demonstrate sleep fragmentation that correlates with depressive symptoms 2

Treatment Considerations

• The American Thoracic Society recommends assessing driving risk in all OSA patients 4
• Avoid medications that may worsen OSA in depressed patients, such as benzodiazepines and some antidepressants that cause weight gain 3
• Consider antidepressants less likely to cause weight gain, such as fluoxetine or sertraline, rather than paroxetine 3

Management of Comorbid OSA and Depression

• Refer patients with depression and suspected OSA for sleep study, initiate CPAP therapy if OSA is confirmed, and monitor depression symptoms after OSA treatment begins 1
• Optimize CPAP therapy and adherence for patients with OSA and depressive symptoms, and consider formal psychiatric evaluation if depression persists despite adequate OSA treatment 1