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The relationship between depressive symptoms and obstructive sleep apnea in pediatric populations: a meta-analysis
Elif Yilmaz1, Karim Sedky, David S Bennett
1Department of Child and Adolescent Psychiatry, Drexel University College of Medicine, Philadelphia, PA.
Insights
Children with obstructive sleep apnea (OSA) show higher depressive symptoms. Treatment with adenotonsillectomy (AT) may improve these symptoms, reducing the need for medication and enhancing overall health.
Area of Science:
- Pediatric Sleep Medicine
- Child Psychiatry
- Otolaryngology
Background:
- Obstructive sleep apnea (OSA) is increasingly linked to depressive disorders in children.
- The precise relationship between pediatric OSA and depression remains unclear.
Purpose of the Study:
- To investigate the association between depressive symptoms and OSA in pediatric populations.
- To evaluate the effectiveness of adenotonsillectomy (AT) in reducing depressive symptoms in children with OSA.
Main Methods:
- A comprehensive meta-analysis was performed on studies published up to January 2013.
- Eleven studies (894 children with OSA, 1096 controls) examined the OSA-depression link.
- Nine studies (379 children) assessed depressive symptoms before and after AT.
Main Results:
- A medium, significant relationship was found between depressive symptoms and OSA (Hedges' g = 0.43, p = 0.0005).
- Adenotonsillectomy (AT) demonstrated a medium, significant improvement in depressive symptoms post-treatment (Hedge's g = 0.41, p ≤ 0.001).
Conclusions:
- Children with OSA exhibit elevated depressive symptoms.
- Screening for sleep-disordered breathing is recommended for children with depressive symptoms.
- AT may alleviate depression, decrease medication use, and improve sleep and health in children with OSA.
Background:
A higher incidence of depressive disorders and symptoms has been suggested among children suffering from obstructive sleep apnea (OSA). Yet, the extent to which OSA is related to increased depression is unclear.
Objectives:
To evaluate (a) the relationship between depressive symptoms and OSA in pediatric populations, and (b) the efficacy of adenotonsillectomy (AT) for decreasing depressive symptoms among children with OSA.
Methods:
A meta-analysis was conducted to assess the relationship between depressive symptoms and OSA, and the efficacy of AT for decreasing depressive symptoms. Studies reporting depressive symptoms of children with OSA through January 2013 were included.
Results:
Eleven studies assessed depressive symptoms in both children diagnosed with OSA (n = 894) and a comparison group (n = 1,096). A medium relationship was found between depressive symptoms and OSA (Hedges' g = 0.43, 95% CI: 0.22-0.64; p = 0.0005). Addressing the second question, 9 studies (n = 379 children) examined depressive symptoms pre- and post-AT. A medium improvement in depressive symptoms was found at follow-up (Hedge's g = 0.41, 95% CI: 0.20-0.62; p ≤ 0.001).
Conclusion:
Our findings suggest that depressive symptoms are higher among children with OSA. Therefore, patients with depressive symptomatology should receive screening for sleep disordered breathing. Treatment of OSA with AT might decrease clinical symptoms of depression, reduce pharmacotherapy, improve sleep patterns, and promote better health.
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