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The effects of breathing-related sleep disorders on mood disturbances in the general population
1Stanford Sleep Epidemiology Research Center, School of Medicine, Stanford University, 3430 West Bayshore Road, Suite 102, Palo Alto, CA 94303, USA. mohayon@stanford.edu
Background:
Results of clinical studies suggest that there may be a relationship between breathing-related sleep disorders and depressive disorders. This study aims to assess the impact of breathing-related sleep disorder on major depressive disorder in the general population.
Method:
A cross-sectional telephone survey was carried out between 1994 and 1999 in the general population of the United Kingdom, Germany, Italy, Portugal, and Spain. A total of 18,980 randomly selected subjects aged 15 to 100 years and representative of the general population of their respective countries participated in the study. The questionnaire included a series of questions about sleep quality, breathing-related sleep disorder symptoms, mental disorders, and medical conditions. Data are presented using point prevalence.
Results:
2.1% of the subjects were found with obstructive sleep apnea syndrome at the time of the interview, and 2.5% had some other type of DSM-IV breathing-related sleep disorder diagnosis. The association of DSM-IV breathing-related sleep disorder diagnosis and major depressive disorder diagnosis was found in 0.8% of the sample. As many as 18% of individuals with a major depressive disorder diagnosis also have a DSM-IV breathing-related sleep disorders diagnosis, and 17.6% of subjects with a DSM-IV breathing-related sleep disorders diagnosis have a major depressive disorder diagnosis. Multivariate models showed that even after controlling for obesity and hypertension, the odds of having a DSM-IV breathing-related sleep disorders diagnosis was 5.26 for individuals with a major depressive disorder diagnosis.
Conclusion:
About 800 of 100,000 individuals have both a breathing-related sleep disorder and a major depressive disorder. The identification of 1 of these 2 disorders should prompt the investigation of the other disorder since nearly a fifth of them have the other disorder.
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