Association between obstructive sleep apnea severity and depression risk: a systematic review and dose-response...

Area of Science:

• Sleep Medicine
• Psychiatry
• Epidemiology

Background:

• Obstructive sleep apnea (OSA) is increasingly recognized as a potential contributor to depressive symptoms.
• Understanding the relationship between OSA severity and depression is crucial for public health.
• Previous studies suggest a link, but a clear dose-response relationship requires further investigation.

Purpose of the Study:

• To systematically review and meta-analyze the dose-response connection between obstructive sleep apnea severity and the risk of depression.
• To quantify the impact of increasing apnea-hypopnea index (AHI) on depression risk.

Main Methods:

• A comprehensive systematic literature search was conducted across multiple databases (PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, CNKI, SinoMed) up to August 28, 2023.
• Included 18 cross-sectional studies with 3143 participants for a dose-response meta-analysis.
• Employed random-effects models to assess linear and nonlinear dose-response relationships and evaluated publication bias.

Main Results:

• Severe OSA was associated with a significantly higher adjusted risk of depression (RR: 1.34, 95% CI: 1.05-1.70) compared to mild OSA.
• A significant linear dose-response relationship was identified between OSA severity and depression risk.
• Depression risk increased by 0.4% for every 1 event per hour increase in the apnea-hypopnea index (AHI).

Conclusions:

• This meta-analysis confirms a significant linear dose-response association between obstructive sleep apnea severity and the risk of developing depression.
• Individuals with more severe OSA face a demonstrably higher risk of depression.
• Findings underscore the importance of addressing OSA severity in the management and prevention of depressive symptoms.