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Does surgery for obstructive sleep apnea improve depression and sleepiness?

Stacey L Ishman1, James R Benke, Aliza P Cohen

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio; Divisions of Pediatric Otolaryngology & Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

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Summary

Surgical treatment for obstructive sleep apnea (OSA) significantly reduced depression and sleepiness in patients. Multilevel surgery showed a 75% resolution rate for depression and 77% for sleepiness.

Keywords:
Beck Depression InventoryEpworth Sleepiness scaledepressionobstructive sleep apneasleepinesssurgery

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Area of Science:

  • Sleep Medicine
  • Surgical Interventions
  • Mental Health

Background:

  • Obstructive sleep apnea (OSA) is a common disorder associated with significant morbidity, including depression and excessive daytime sleepiness.
  • Surgical interventions are explored as a treatment option for OSA, but their impact on associated psychological and functional symptoms requires further investigation.

Purpose of the Study:

  • To evaluate the efficacy of surgical treatment, particularly multilevel surgery, in reducing depression and sleepiness in patients with obstructive sleep apnea.
  • To identify predictors of depression improvement following OSA surgery.

Main Methods:

  • A prospective cohort study involving chart and outcome database review of 44 patients who underwent OSA surgery.
  • Pre- and post-operative assessments included the Epworth Sleepiness Scale (ESS), Beck Depression Index (BDI), and polysomnography.
  • Multivariable regression analysis was used to identify predictors of depression improvement.

Main Results:

  • Surgical treatment led to a significant reduction in the obstructive respiratory disturbance index (RDI) from 35.8 to 17.1 events/hour (P < 0.0001).
  • Mean ESS scores improved significantly (P = 0.0001), and mean BDI scores decreased significantly (P = 0.0051).
  • Surgery resolved excessive daytime sleepiness in 77.3% of patients and depression in 75.0% of patients.

Conclusions:

  • Multilevel surgical treatment for OSA effectively reduces depression and sleepiness, with high resolution rates for both conditions.
  • Improved sleepiness scores, rather than OSA severity (RDI), predicted improvement in depression.
  • Further research with larger sample sizes and control groups is recommended to validate these findings.