Persistent Depression Despite CPAP? Treat Daytime Sleepiness.

Untreated sleep apnea is associated with depression symptoms. The treatment with CPAP (Continuous Positive Airway Pressure) improves these symptoms in most, but not all patients.

In this multicenter prospective cohort study published in January 2014 CHEST journal, researchers evaluated 300 patients with OSAHS and depressive symptoms.

After an average of 529 days of CPAP therapy, the mean depression score decreased from 9.2 to 5.4 (p<0.0001), but 125 (41.7%) patients presented persistent depressive symptoms. The persistence of depressive symptoms was independently associated with persistent excessive daytime sleepiness (EDS), comorbid cardiovascular disease, and female gender.

Persistent depressive symptoms are strongly associated with Excessive Daytime Sleepiness. Active monitoring of depressive symptoms is needed in CPAP-treated OSAHS patients.