Predictors of Depression among Individuals with OSAS: A Cross-Sectional Study from Turkiye.

BACKGROUND

Obstructive sleep apnea syndrome (OSAS) has been increasingly associated with mood disturbances, particularly depression, through mechanisms involving neuroinflammation, altered neurotransmitter activity, and impaired sleep quality. It has been suggested that changes in sleep patterns may serve as effective biomarkers of depression.

AIM: To assess the frequency of depressive symptoms and their association with excessive daytime sleepiness (ES), sleep quality, and hypoxemia in individuals diagnosed with OSAS.

METHODS

The study population included all consecutive individuals who were newly diagnosed with OSAS in the Sleep Disorders Center between April and June 2024. All 150 patients included in the study sample underwent polysomnography (PSG) and were administered the Epworth Sleepiness Scale (ESS), the Geriatric Depression Scale, Long Form (GDS-LF), and the Pittsburgh Sleep Quality Index (PSQI). Hypoxemia burden was determined primarily based on the time spent with oxygen saturation below 90% during the night (TST 90).

RESULTS

The mean age of the study participants was 54.8 ± 7.7 years, and 33.3% were females. About 84% of the study participants had poor sleep quality, and 45.3% and 38% had depressive symptoms. In univariate analysis, female gender (P = 0.002), higher PSQI score (P < 0.001), higher oxygen desaturation index (P = 0.040), and lower AHI (P = 0.048) were associated with depression. In multivariate analysis, male gender (OR: 0.307, 95% CI: 0.133-0.708, P = 0.006) and higher PSQI score (OR: 1.290, 95% CI: 1.146-1.453, P < 0.001) remained significant independent predictors of depression, whereas AHI and hypoxemia burden were not significantly associated.

CONCLUSIONS

Poor sleep quality and female gender are independent predictors of depression in OSAS patients, while AHI and hypoxemia burden do not appear to have a significant effect. These findings highlight the importance of assessing and addressing sleep quality, particularly in female OSAS patients, to improve mental health outcomes.