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Updated: May 18, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Depressive symptoms and childhood sleep apnea syndrome
Marco Carotenuto1, Maria Esposito, Lucia Parisi
1Sleep Clinic for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy.
Insights
Sleep-related breathing disorders (SRBD) are linked to higher depression scores in children. Assessing mood in children with SRBD is crucial for early intervention and better health outcomes.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychiatry
- Respiratory Medicine
Background:
- The link between sleep disturbances and mood regulation is established.
- Sleep-related breathing disorders (SRBD) are increasingly suspected in the development of childhood depression.
- However, conclusive clinical data remain limited.
Purpose of the Study:
- To investigate the association between SRBD and depressive symptoms in school-aged children.
- To identify potential risk factors for depression in children with SRBD.
Main Methods:
- A cohort of 94 children with SRBD and 107 healthy children was studied.
- Overnight respiratory evaluation assessed SRBD severity (apnea-hypopnea index, oxygen desaturation index).
- The Italian version of the Children Depression Inventory (CDI) screened for depressive symptoms.
Main Results:
- Children with SRBD exhibited significantly higher CDI scores compared to controls.
- CDI scores positively correlated with apnea-hypopnea index and oxygen desaturation index.
- An apnea-hypopnea index ≥ 3 and oxygen desaturation index ≥ 1 were identified as risk factors for depressive symptoms.
Conclusions:
- Mood assessment is vital for children diagnosed with SRBD.
- Early identification of depressive symptoms in this population may improve management.
Background:
The relationship between sleep and mood regulation is well known, and some reports suggest a key role of sleep-related breathing disorders (SRBD) in the development of the symptomatology of depression, even if no conclusive data are actually found in the clinical literature. The aim of this study was to assess the relationship between SRBD and depressive symptoms in a population of school-aged children.
Methods:
The study population comprised 94 children affected by SRBD and 107 healthy children. To identify the severity of SRBD, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Children Depression Inventory (CDI) to screen for the presence of depressive symptoms.
Results:
The group with SRBD showed higher CDI scores than the group without SRBD, with a positive correlation found between CDI scores, apnea-hypopnea index, and oxygen desaturation index values. Logistic regression showed that an apnea-hypopnea index ≥ 3 and an oxygen desaturation index ≥ 1 could be risk factors for development of depressive symptoms. According to receiver-operating characteristic curve analysis, the cutoff point for the apnea-hypopnea index that could cause a pathological CDI score (≥19) was >5.66, and the cutoff point for the oxygen desaturation index was >4.2. The limitations of this study are that our data are derived from one single psychometric test and not from a complete psychiatric evaluation, and our subjects came from a small group in southern Italy.
Conclusion:
Our results suggest the importance of mood assessment in children affected by SRBD.
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