Nasal CPAP Improves the Quality of Life and Lessens the Depressive Symptoms in Patients with Obstructive Sleep Apnea Syndrome

• Published in: Internal Medicine Vol. 44; no. 5; pp. 422 - 427
• Main Authors: AKASHIBA, Tsuneto, AKAHOSHI, Toshiki, KAWAHARA, Seiji, HORIE, Takashi
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.05.2005; Japanese Society of Internal Medicine
• Subjects: Biological and medical sciences; Body Mass Index; Continuous Positive Airway Pressure; Depressive Disorder - psychology; Depressive Disorder - therapy; Electroencephalography; Epworth sleepiness scale; excessive daytime sleepiness; Female; Follow-Up Studies; General aspects; Humans; Male; Medical sciences; Middle Aged; nasal continuous positive airway pressure; obstructive sleep apnea syndrome; Pneumology; Polysomnography; Quality of Life; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; self-rating depression scale; Severity of Illness Index; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - psychology; Sleep Apnea, Obstructive - therapy; Surveys and Questionnaires; Treatment Outcome; Mood disorder; Human; Nervous system diseases; Sleep apnea syndrome; Internal medicine; Respiratory disease; Continuous; Depressions; Evaluation scale; excessive daytime sleepiness; Depression; Nasopharynx; Self; Obstruction; Quality of life; Respiratory tract; self- rating depression scale; Positive pressure; Nose; nasal continuous positive airway pressure; obstructive sleep apnea syndrome; Epworth sleepiness scale
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.44.422

Objective To assess changes in response to nasal continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea syndrome (OSAS) concerning excessive daytime sleepiness (EDS), depressive state, and quality of life (QOL). Patients and Methods We assessed for EDS using the Epworth sleepiness scale (ESS), for mood using The Zung self-depression scale (SDS), and for QOL using Short-Form 36 (SF-36) in 132 patients with obstructive sleep apnea syndrome (OSAS) and control subjects. Patients had severe OSAS (apnea-hypopnea index, 59.4±23.8/h) and were more hypersomnolent and depressed, and had poorer QOL than 38 age- and gender-matched controls. Results Before treatment most QOL domains in the SF-36 were significantly associated with patients’ SDS scores. With nasal CPAP, ESS and SDS scores were respectively decreased from 9.7±4.5 to 4.0±2.4 (p<0.0001) and from 49.2±10.4 to 45.1±9.6 (p<0.0005). Total SF-36 score and scores for seven of eight domains were increased significantly with treatment. Thus, nasal CPAP lessens EDS and depression, and improves QOL, in patients with severe OSAS. Further, magnitudes of changes in total SF-36 scores and in five of eight domains correlated significantly with magnitude of change in SDS score upon nasal CPAP treatment. No relationship was evident between treatment-associated score changes in SF-36 domains and ESS score change. Conclusion Although patients with severe OSAS have poorer QOL than control subjects, nasal CPAP appears to improve QOL by alleviating depression.