The Influence of the Treatment of Obstructive Sleep Apnea Syndrome on Depression, Anxiety, and Quality of Life

Introduction: Psychiatric diseases may co-exist with obstructive sleep apnea syndrome (OSAS). We examined the presence of this comorbidity on the quality of life and sexual life, and the beneficial effects of OSAS treatment. Materials and Methods: A total of 79 consecutive patients newly admitted to the Sleep Disorders Unit were investigated with a psychiatric interview and whole-night polysomnography. DSM-IV-TR criteria were used and the Beck Depression and Anxiety Scales (BDS and BAS), the 36-item Short Form health survey (SF-36), and the Arizona Sexual Experiences Scale (ASEX) were administered. After one month of treatment with non-invasive mechanical ventilation, all investigations were repeated. Results: Of 48 patients with OSAS, major depression was present in 13 patients (27%), anxiety disorders in 3 patients (6.2%), and major depression and anxiety disorders were both present in 11 patients (22.9%). Following one month of OSAS treatment, major depression was observed in 5 patients (10.4%), anxiety disorder in 1 patient (2.0%), and both major depression and anxiety disorder (p=0.001) were found in 9 patients (18.7%). After treatment, significant improvements were detected in both BDS (p=0.001) and BAS scores (p=0.002). There was no significant difference in ASEX scores (p=0.165). Comparison of SF36 sub-scales scores before and after OSAS treatment demonstrated significant improvements in quality of life measures. The significance was more pronounced in patients with severe OSAS. Discussion: It is of great importance to keep in mind the comorbidity of OSAS and psychiatric diseases such as drug resistant depression and anxiety disorders, as treatment of OSAS provides a marked benefit in depression, anxiety, and also in quality of life.