Obstructive Sleep Apnea
Obstructive sleep apnea is an illness characterized by snoring, partial or complete cessation of breathing during sleep, reductions in blood oxygen levels, severe sleep fragmentation, and excessive daytime sleepiness. Researchers and clinicians have recognized sleep apnea as one of the most common sleep disorders and with perhaps the greatest medical and social impact on society in terms of morbidity and mortality. The syndrome strikes both sexes and all races, ages, socioeconomic strata, and ethnic groups.
The Apnea-Depression Connection
The relationship between depression and obstructive sleep apnea (OSA) is confounded by the shared morbidities of fatigue, change in appetite causing a change in weight, difficulty concentrating, irritability, sexual dysfunction and loss of interest in enjoyable activities.
With this symptoms in common, there is most likely an extraordinarily high amount of misdiagnoses, as well as misdirected therapy as a result. It would be beneficial for clinicians to recognize the relationship between OSA and depression before diagnosing a depressive disorder presumptively and, perhaps, prescribing antidepressant medication inappropriately. Unfortunately, consideration of an unsuccessful re sponce to treatment for depression.
DiagnosisÂ
A patient presenting with fatigue, depression or problems in social relationships might have a primary problem of sleep apnea. If so, treatments appropriate for depression may miss the mark. If snoring, gasps, or pauses in breathing during sleep are reported, referral to an expert in sleep disorders for evaluation may be appropriate. A simple questionnaire may be all that is needed to pinpoint suspicious symptoms.
Treatment
Diagnosis is made on the basis of the clinical picture, patient and spouse reports, and an overnight polysomonogram . Effective treatment eliminates snoring and apnea. The success of treatment is measured by the reduction of respiratory disturbance to normal levels, by the elimination of symptoms like fatigue and depression, and the patients subjective feeling of well-being.
The” gold standard” treatment accepted by physicians and other trained in sleep disoreders medicine is the continuous application of positive air pressure through a mask during sleep (Continuous Positive Pressure– CPAP) The additional air pressure keeps the airway from collapsing. Since this permits normal sleep patterns emerge, sleep becomes restorative, and the patient feels better.
