Evaluation of depression and quality of life in patients with obstructive sleep apnea syndrome

Abstract

Background: Sleep fragmentation, repetitive hypoxemia during sleep, excessive sleepiness during the day, lack of concentration, memory loss, depression, decreased libido, and impotence are the characteristics of obstructive sleep apnea syndrome (OSAS) that may impair quality of life (QOL). This study aimed to investigate the QOL and factors that may affect QOL in people with different OSAS severity and without sleep apnea.

Methods: This was an analytical cross‑sectional study. Polysomnography was performed on 200 people. Those detected as having nonapnea and mild‑moderate‑severe OSAS were administered the Epworth sleepiness scale, Beck Depression Inventory, and the World Health Organization Quality of Life‑BREF (WHOQOL‑BREF) scale.

Results: According to the apnea‑hypopnea index, 36 people (18.0%) were in the nonapnea‑hypopnea group, 28 (14.0%) in the mild OSAS group, 63 (31.5%) in the moderate OSAS group, and 73 people (36.5%) were in the severe OSAS group. Depression was present in 31 people (15.5%) who participated in the study. The nonapnea‑hypopnea group comprised 12.9% of those with depression, mild OSAS group comprised 16.1%, moderate OSAS group comprised 22.6%, and severe OSAS group had 48.4% of the depressed subjects. Beck depression scores showed a significant positive correlation with the Epworth scale (t < 90% SaO₂) (r = 0.285, P < 0.001 and r = 0.283, P < 0.001, respectively). The mean scores of WHOQOL‑BREF subgroups’ physical health (P < 0.001), psychological health (P < 0.001), social relations (P < 0.001), and the environmental area (P < 0.001) in those with depression were statistically significantly lower than those without depression. QOL was significantly associated with the presence of OSAS (P = 0.008).

Conclusion: Decreased deep sleep duration, increased arousal index, and a high ratio of sleep duration with oxygen saturation below 90% to the duration of the entire sleep period increase daytime sleepiness and depressive symptoms in those with OSAS; thus, disrupting general health and QOL.

Keywords: Depression, obstructive sleep apnea, quality of life