There is a complex relationship between sleep and depressive illness. Depression can cause sleep problems and sleep problems can cause or contribute to depressive disorders. As dentists offering dental sleep medicine services, we can continue to be our patients’ first line of defense against sleep apnea and other conditions, such as depression.
Understanding the Connection
Sleep-disordered breathing has been linked with depression. This is especially true because insomnia is very common among depressed patients.
Depressed individuals may suffer from a range of insomnia, including:
- Difficulty falling asleep
- Difficulty staying asleep
- Un-refreshing sleep
- Daytime sleepiness
However, research suggests the risk of developing depression is highest among people with both sleep onset and sleep maintenance insomnia. Obstructive sleep apnea (OSA) is also linked with depression.
One study worked to assess the quality of life (QOL) in patients with severe OSA. The results showed that QOL of patients with severe OSA was decreased compared with normal control subjects. As a result, the QOL of patients strongly correlated with depression. However, excessive daytime sleepiness score and oxygen desaturation during sleep also did affect the QOL, but the magnitude of its effect was small.1
Diagnosis and Treatment of Sleep Apnea
The good news is that treating OSA may improve depression. And, in many cases, because symptoms of depression often overlap with symptoms of sleep apnea, there can be a risk for misdiagnosis. By partnering with your patient’s physician, you can properly treat sleep apnea and depression.
For those who are experiencing symptoms of depression, it is important for them to be screened for sleep apnea. You can begin this screening by asking if they are experiencing any of the following symptoms:
- Breathing pauses while sleeping
- Disrupted sleep
- Excessive daytime sleepiness
The solution is simple—offer treatment for sleep apnea or depression right away. By treating sleep apnea, you can help to not only improve your patients’ sleep, but their depression as well. Whether treatment is for depression or sleep apnea, the end result will be the same: a better night’s sleep and an improved well-being.
If you are offering dental sleep medicine services in your practice, what are you doing about depression? Gaining a better understanding of the connection between sleep apnea and depression is key to helping our patients get the best care possible. With proper treatment, we hope to not only provide relief from sleep apnea, but depression as well.
Mayoor Patel, DDS, MS, is the owner of Atlanta’s Craniofacial Pain and Dental Sleep Center of Georgia.
1. Akashiba T, Kawahara S, Akahoshi T, Omori C, Saito O, Majima T, Horie T. 2002. Relationship Between Quality of Life and Mood or Depression in Patients With Severe Obstructive Sleep Apnea Syndrome. Chest,122(3), 861-865. doi:10.1378/chest.122.3.861
I am 38yo, 5’9″ and 173lbs. I have been using PAP therapy for nearly 11yrs. Some of my symptoms have cleared, PAP is not a 100% fix I know that. I still awaken unrefreshed, occasional headaches; my AHI is 3.1. My mood improved improved a bit, however, I was recently diagnosed with double-depression and anxiety disorder and was prescribed 40mg Prozac. That doesn’t seem to be helping as much as I thought it would, its a roller coaster. It almost feels as if I traded one sack of problems or another. Apnea and depression seem to be hand in hand for me. My MDs don’t really have much to say or idea understanding of this and I suspect they will want to increase my med dose. Any feedback on what could possibly be happening would be appreciated.
Have you seen a connection between Dysthymia depression and sleep apnea. How can one prove clinically that sleep apnea manifested from mental health or vice versa?
I was diagnosed with Dysthymia disorder/ major depression in active duty. Through my years of service and diagnose condition I experience symptoms of sleep apnea and report to medicalprofessionals, but I was not warrant a sleep test. 1 year after separating from service and depression worsening, I was given a sleep test and diagnosed with OSA.
How can I prove medically that the symptoms I was experiencing for both medical issue were in fact mental health and sleep apnea?