Sleep Apnea Strongly Linked to Depression

sapphoq healing tbi says: Here's some stats for those of you who have not heard me repeat them a gazillion times before:
The most common area of injury to the brain in a t.b.i. is the left frontal-temporal lobe region-- the region that is responsible for the regulation of seretonin reuptake and is thought to be involved in major depression.
50% of all patients with a diagnosed traumatic brain injury also have a sleeping disorder.
33% of all mental health outpatients have an UNDIAGNOSED tbi.

If you have been diagnosed with a traumatic brain injury and are suffering from irritractible fatigue, get to an ear-nose-throat specialist and get screened for sleeping disorders. I am glad I did!


Article pasted from http://www.medscape.com/viewarticle/544731

Sleep Apnea Strongly Linked to Depression


NEW YORK (Reuters Health) Sept 18 - Sleep-related breathing disorder (SRBD) has a robust association with depression, according to results of a longitudinal study funded by the National Institutes of Health and published in the Archives of Internal Medicine for September 18.

Based on their findings, the investigators advise that, for patients with SRBD, "Medical treatment (eg, continuous positive airway pressure therapy) or behavioral modification of SRBD (eg, weight loss) may help mitigate or prevent depressive symptoms."

While cross-sectional studies have suggested a relationship between the two disorders, there have been no population-based, longitudinal studies of SRBD assessed by polysomnography as a risk factor for depression, according to lead investigator Dr. Paul E. Peppard and colleagues, based at the University of Wisconsin-Madison.

The Wisconsin Sleep Cohort Study started recruiting subjects who were employees of state agencies aged 30 to 60 years in 1988. Subjects were scheduled to undergo overnight polysomnography every 4 years.

Degree of sleep-related breathing disorder was defined according to apnea-hypopnea index (none = 0 events/hour, minimal = 1 to 4 events/hour, mild = 5 to 14 events/hour, and moderate or worse as 15 or more events/hour). Assessment of depression was based on Zung self-report depression scale and with antidepressant use.

The study cohort was comprised of 1408 participants with 3202 sleep studies.

The authors observed significant dose-response trends of increasing risk of depression with increasing SRBD severity. After adjusting for age and gender, the odds ratio of depression when compared with no breathing disorder was 1.6 for minimal SRBD, 2.0 for mild SRBD, and 2.5 for moderate or worse SRBD (p value for trend < 0.001).

Fully adjusted longitudinal data showed that a two-category transition (for example, from no SRBD to mild SRBD) was associated with an odds ratio for depression of 3.3.

The risk of depression was not altered much by adjusting for other cofactors, such as daytime sleepiness or use of benzodiazepines, Dr. Peppard's team reports. Nor was the association between the two disorders reflective of specific components of depression.

Dr. Peppard's team speculates that, "If SRBD is causally related to depression, it seems likely that pathways initiating with cardinal features of SRBD, for example, sleep fragmentation and intermittent hypoxia, are involved."

Arch Intern Med 2006;166:1709-1715