Sleep apnea severity and depressive symptoms in a population-based study

Annemarie I Luik; Jenna Noteboom; Lisette A Zuurbier; Harry Whitmore; Albert Hofman; Henning Tiemeier

doi:10.1016/j.sleh.2015.03.002

Sleep apnea severity and depressive symptoms in a population-based study

Sleep Health. 2015 Jun;1(2):128-132. doi: 10.1016/j.sleh.2015.03.002. Epub 2015 Apr 22.

Authors

Annemarie I Luik¹, Jenna Noteboom¹, Lisette A Zuurbier¹, Harry Whitmore², Albert Hofman¹, Henning Tiemeier³

Affiliations

¹ Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
² Section of Endocrinology in the Department of Medicine, University of Chicago, Chicago, IL, USA.
³ Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: h.tiemeier@erasmusmc.nl.

PMID: 29073376
DOI: 10.1016/j.sleh.2015.03.002

Abstract

Objectives: Sleep apnea and depression often co-occur in clinical studies, but population-based studies demonstrated mixed results. We determined the association of sleep apnea severity and depressive symptoms in a population-based sample.

Design: Cross-sectional cohort study.

Setting: Population-based.

Participants: Four hundred ninety-one middle-aged and elderly persons of the Rotterdam Study (mean age 61.9 years; standard deviation, 5.4).

Measurements: Polysomnography recordings were collected to calculate the apnea hypopnea index (AHI). Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale.

Results: In the total sample, no associations for the severity of sleep apnea with depressive symptoms were found (multivariate adjusted: B = 0.032; 95% confidence interval [CI], -0.057 to 0.122). Only in men we found some evidence for a curvilinear association of the severity of sleep apnea with depressive symptoms (multivariable adjusted: B = -0.126; 95% CI, -0.224 to -0.028); men with an AHI between 5 and 15 (multivariable adjusted: B = 0.378; 95% CI, 0.037-0.718) or between 15 and 30 (multivariable adjusted: B = 0.502; 95% CI, 0.152-0.852) had significantly more depressive symptoms than those with an AHI equal to or greater than 30.

Conclusions: In this population-based sample, the severity of sleep apnea is not consistently related to depressive symptoms, although there was some evidence for an association of AHI with depressive symptoms in men.

Keywords: Depression; Depressive symptoms; Epidemiology; Polysomnography; Sex; Sleep apnea.