Major depressive disorder (MDD) and obstructive sleep apnea (OSA) are two conditions that are prevalent in the general population. Studies have shown that the two conditions are bidirectionally associated and lead to poor health outcomes. The prevalence of comorbid MDD in patients with OSA could reach two-thirds. In this article, we will discuss the evaluation method and treatment of both conditions, as well as the importance of early detection and effective treatment of MDD and OSA.
A large cohort study showed a higher prevalence of psychiatric comorbidities, such as mood and anxiety disorders, in patients with OSA than in patients without OSA. Another cohort study described the prospective association between OSA and subsequent depressive disorders within the first year of their onset. A sedentary lifestyle and psychological stress in the era of globalization may increase the risk of suffering from MDD and OSA.We present a case of a patient with nervous hyperactivity disorder with OSA, we analyzed the evaluation method and also reviewed the treatment of both conditions. Our goal was to raise awareness among psychiatrists to differentiate other medical conditions when the symptoms of MDD are atypical and do not respond to standard psychiatric treatment.In general, most prevalence studies were based on referrals to sleep clinics or psychiatric inpatient populations.
In light of the heterogeneity of the study populations, participants in these studies should be diagnosed with OSA following the criteria recently introduced by the ICSD-3, and the use of standard sleep results should be encouraged to ensure that comparisons between studies are possible in the future.Decreased levels of serotonin in the body increase the chance that the upper part of the throat will collapse, leading to sleep apnea. This made the patient more concerned that he would feel exhausted and lose concentration, and that he would not be able to work if he could not sleep enough. To further complicate the relationship between schizophrenia and OSA, smoking and alcohol consumption are thought to increase the risk of suffering from sleep apnea, and these two behaviors are also very common in people with schizophrenia.He had no sleep bruises, periodic limb movements during sleep, parasomnia, sleep paralysis, cataplexy, or hypnagogic or hypnopompic hallucinations. The most popular scales, such as the Beck Depression Inventory (BDI), the Mood Profile (POMS) and the Minnesota Multiphasic Personality Inventory (MMPI), raise questions related to sleep symptoms, such as insomnia and fatigue, which are common in both OSA and psychiatric conditions.Finally, she received an injection of liraglutide and oral antihyperglycemic medications, and the internist also advised her to return to the sleep disorders center and continue with the psychiatrist.
The polysomnographic evaluation of treatment-resistant psychiatric patients (e.g. MDD and PTSD) can be considered an excellent tool for determining whether a sleep disorder is complicating a treatment-resistant psychiatric disorder.The calming effects of sleep medications and benzodiazepines can have direct effects on breathing during sleep, causing airway obstruction. Sleep specialists suspected obstructive sleep apnea and offered to perform a nighttime polysomnogram; however, she lost follow-up at the sleep disorders center.The study aimed to assess the prevalence of mental illness in obstructive sleep apnea (OSA) and to examine whether patients with obstructive sleep apnea need to be tested for mental illness. Early detection and effective treatment of MDD and OSA are essential to achieving patient outcomes.
In addition, it can reduce the complications of both conditions. Therefore, a thorough evaluation should be performed to determine diagnoses when clinicians suspect that TDM and OSA overlap. In conclusion, MDD is one of the most common psychiatric illnesses associated with obstructive sleep apnea. Early detection is key for successful treatment outcomes for both conditions.
It is important for psychiatrists to be aware that symptoms of MDD may be atypical when there is an underlying medical condition such as OSA.