Sleep apnea severity and depressive symptoms in a population-based study.
Luik AI., Noteboom J., Zuurbier LA., Whitmore H., Hofman A., Tiemeier H.
OBJECTIVES: Sleep apnea and depression often co-occur in clinical studies, but population-based studies demonstrated mixed results. We determined the association of sleep apnea severity and depressive symptoms in a population-based sample. DESIGN: Cross-sectional cohort study. SETTING: Population-based. PARTICIPANTS: Four hundred ninety-one middle-aged and elderly persons of the Rotterdam Study (mean age 61.9 years; standard deviation, 5.4). MEASUREMENTS: Polysomnography recordings were collected to calculate the apnea hypopnea index (AHI). Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. RESULTS: In the total sample, no associations for the severity of sleep apnea with depressive symptoms were found (multivariate adjusted: B = 0.032; 95% confidence interval [CI], -0.057 to 0.122). Only in men we found some evidence for a curvilinear association of the severity of sleep apnea with depressive symptoms (multivariable adjusted: B = -0.126; 95% CI, -0.224 to -0.028); men with an AHI between 5 and 15 (multivariable adjusted: B = 0.378; 95% CI, 0.037-0.718) or between 15 and 30 (multivariable adjusted: B = 0.502; 95% CI, 0.152-0.852) had significantly more depressive symptoms than those with an AHI equal to or greater than 30. CONCLUSIONS: In this population-based sample, the severity of sleep apnea is not consistently related to depressive symptoms, although there was some evidence for an association of AHI with depressive symptoms in men.