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Sleep Apnea, Depression Linked in Stanford Study.

News Editors/Health/Medical Writers

STANFORD, Calif.--(BUSINESS WIRE)--Nov. 6, 2003

People with depression are five times more likely to have a breathing-related sleep disorder Sleep disorder
Any condition that interferes with sleep. At least 84 have been identified, according to the American Sleep Disorders Association.

Mentioned in: Insomnia, Night Terrors
 than non-depressed people, according to a study at the Stanford University School of Medicine Stanford University School of Medicine is affiliated with Stanford University and is located at Stanford University Medical Center in Stanford, California, adjacent to Palo Alto and Menlo Park. . The study is the first to show a link between depression and sleep apnea sleep apnea, episodes of interrupted breathing during sleep. Obstructive sleep apnea is a common disorder in which relaxation of muscles in the throat repeatedly close off the airway during sleep; the person wakes just enough to take a gasping breath.  along with its related disorders.

Although it remains unclear how the conditions are linked, Maurice Ohayon, MD, PhD, said his study should encourage physicians to test depressed patients for this type of sleep disorder.

"Physicians who see people with depression shouldn't stop at the first diagnosis, but instead look into the presence of a breathing-related sleep disorder," said Ohayon, an associate professor of psychiatry and behavioral sciences behavioral sciences, those sciences devoted to the study of human and animal behavior.
. His study appears in the current issue of the Journal of Clinical Psychiatry.

These disorders include such breathing anomalies as chronic, disruptive snoring snoring, rough, vibratory sounds made in breathing during sleep or coma. The noisy breathing is the result of an open mouth and a relaxation of the palate; it is frequently induced by lying on one's back.  and obstructive sleep apnea Obstructive sleep apnea (OSA)
A potentially life-threatening condition characterized by episodes of breathing cessation during sleep alternating with snoring or disordered breathing.
 syndrome, a disorder in which people stop breathing for brief periods up to hundreds of times a night. Left untreated, the disorders can lead to hypertension, stroke and cognitive deterioration. They can also affect a person's daily routine and disrupt his or her familial, social and professional life.

"This type of disorder increases a person's chances of feeling sleepy and irritable, having a dispute with a family member or colleague, or getting into a traffic accident," said Ohayon.

Several studies have suggested that sleep apnea is associated with a higher rate of depressive disorder depressive disorder Psychiatry Any of a number of conditions characterized by one or more depressive episodes–major DD, depressed mood–dysthymic disorder and adjustment disorder with depressed mood, and those that do not fit the criteria of other  and that treating sleep apnea could help control depression in patients. But no previous study had explored this association and its risk factors in the general population.

To assess the impact of the two disorders in the general population, Ohayon conducted a telephone survey with adults in five countries (the United Kingdom, Germany, Italy, Portugal and Spain). More than 18,000 people were chosen as a representative sample of 206 million Europeans. The participants answered questions pertaining to sleep quality and schedules, breathing-related sleep disorders Sleep Disorders Definition

Sleep disorders are a group of syndromes characterized by disturbance in the patient's amount of sleep, quality or timing of sleep, or in behaviors or physiological conditions associated with sleep.
, mental disorders and medical conditions.

After analyzing the data, Ohayon found that 2.1 percent of the people surveyed had sleep apnea -- a figure consistent with data from past studies on selected populations -- and 2.5 percent had another type of breathing-related sleep disorder. Eighteen percent of respondents who were experiencing a depressive disorder (4 percent of all respondents) also had a breathing-related sleep disorder, compared with 3.8 percent of non-depressed respondents. That represents a five-times increased likelihood of breathing-related sleep disorders among depressed people.

"This is the first study to show the strength of the link between the two disorders," said Ohayon, adding that even after controlling for obesity and hypertension (important factors in each disorder) the association remained strong.

It remains unclear whether depression occurred before or after sleep apnea, and to what extent sleep apnea contributes to the maintenance or aggravation of depression. Ohayon said the link between treating sleep apnea syndrome sleep apnea syndrome Ondine's curse A condition defined by frequent episodes of sleep apnea, hypopnea, and Sx of functional respiratory impairment; it is potentially life-threatening, and associated with daytime hypersomnolence, MVAs, and cardiovascular M&M in  and the evolution of depressive disorders needs further investigation. He hopes physicians will consider the association between the disorders and depression when treating depressed patients. "Once people have their sleep apnea recognized, there is a lot we can do to help them," he said.

Ohayon received funding for his research from the Medical Research Council of Quebec and an unrestricted educational grant from the Sanofi-Synthelabo Group, a pharmaceutical company.

Stanford University Medical Center Stanford University Medical Center (Stanford Hospital & Clinics) is one of four hospitals affiliated with Stanford University and Stanford University School of Medicine, along with the Lucile Packard Children's Hospital, the Veteran's Administration Hospital in Palo Alto, and Santa  integrates research, medical education and patient care at its three institutions -- Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital Lucile Packard Children's Hospital (LPCH) is a hospital located on the Stanford University campus in Palo Alto, California. It is staffed by over 650 physicians and 4,750 staff and volunteers.  at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at
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Date:Nov 6, 2003
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