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Profile IconBLev and bruce david joined SleepGuide
Aug 21
Sleep Apnea Depression. If you're asking which one it is, sleep apnea or depression, you're in good company: unfortunately, primary care physicians, psychiatrists, psychologists and patients often confuse sleep apnea and depression. Understandably so. Loss of energy, loss of interest in once enjoyable things, difficulty concentrating and fatigue are common symptoms of depression. But they are also common symptoms of sleep apnea, and new research is continually emerging to show the connection between the two. An article published in the September 2005 issue of the journal Chest concluded that many patients with depression symptoms improved markedly when treated with CPAP. The study showed that of those being treated with CPAP, 40 of the 41 participants taking antidepressants and those not taking them showed decreases in their depression scores.

But if you're relying solely on the opinion of your psychiatrist to treat your depression, a referral to a sleep physician is not likely. Why? Pharmaceutical companies spend tens of millions of dollars in advertising each year to convince psychiatrists and the general public that antidepressants are the way to treat depression. What about when antidepressants don't work? MORE antidepressants! The pharmaceuticals have created a new category of antidepressants which they call "Add-On" antidepressants. By its own admission, one pharmaceutical company that puts out the "Add-On" medication Abilify (aripiprazole) acknowledges that "studies show that approximately two-thirds of those diagnosed with depression did not achieve adequate symptom relief after taking an antidepressant alone."

The bottom line is that if you suffer from depression, and have one or more of the signs of sleep apnea, such as snoring, you'd do yourself a favor by getting evaluated by a sleep physician and not just a psychiatrist. I can tell you from personal experience that this is a good idea. I did it and it changed my life.

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Comment by Gordon Osmond on February 18, 2009 at 3:15am
It's surprising that so many of us have responded to this story. I have had a nervous breakdown and continue to receive some treatment. But, since using my Cpap machine, I am so much calmer.
Comment by Dawn on February 17, 2009 at 10:55pm
Oh my gosh.....before I was ever diagnosed with sleep apnea I was told I had depression and anxiety and prescribed antidepressants. I gave the meds a good long while to see if they would work, but all they really did was make my horrible insomnia worse. Then my body really had a fit: blood pressure out of control, horrible swelling in my legs and finally a diagnosis of pulmonary hypertension. Yep, I was mentally and physically a wreck. I weaned off of the antidepressants. I finally was diagnosed with sleep apnea. After using CPAP not only are my physical symptoms way better, I also emotionally feel better. I feel relaxed and have the reserve to deal with things. I am not depressed and I am not anxious. I do not have insomnia anymore: I fall asleep as soon as I get the CPAP going. My htn is better, my legs are not really swollen anymore and my pulmonary hypertension is way better. And I also have one additional bonus benefit of having sleep apnea successfully treated: I have my creative spark back!
Comment by Sleepguy on February 17, 2009 at 6:20pm
I met a doctor who joined the Sleep Medicine program at LSU in a rather unusual way. He was had a growing practice in internal medicine after a full residency, licencing, etc. Somehow he discovered apnea and over the course of two years found that every single one of his heart patients, 100%, were suffering from undiagnosed sleep apnea. All of them.

He left his practice and was able to join as a new faculty member at LSU in sleep medicine. He wants to make a difference and feels like he really found his "calling."

Banyon, there's a very simple screening tool called the Berlin Questionnaire. Ten questions. It takes just a few moments to score. For people in the "high risk" category, the questionnaire has been proven to have 89% "positive predictive value." Almost 90% of the high risk category will have SDB diagnosed in a sleep study. I am baffled that this little screening tool isn't used across the board by primary care doctors, counselors, therapists, etc.
Comment by Banyon on February 17, 2009 at 6:09pm
Sleepguy wrote: "I was on the verge of a complete breakdown."

It was the same for me; depression and extreme anxiety. The psychiatrist threw prescriptions (Prozac, Paxil, Effexor) at the problem. The mental health counselor "discovered" some trauma in my childhood that "caused" it. During many visits to these two professionals and a family physician, I was never screened for SDB.

Once I got a CPAP and tweaked it to achieve a good therapy, the anxiety and depression came to a quick end. I take no drugs now and certainly don't need a counselor.

Somehow, psychiatrists and mental health counselors need to be held responsible for screening all of their patients for SDB and referring them if the screening is positive. A local sleep doctor has kept records and says more than half of patients coming to his sleep lab have already been prescribed antidepressants (inappropriately in his opinion).

Psychiatrists, counselors and family physicians should routinely and consistently screen for SDB. They will fight this because it means that more than half of their market will disappear.

Spread the word.
Comment by Sleepguy on February 17, 2009 at 5:45pm
Depression isn't a really good word to describe my pre-CPAP mental / emotional condition. I was on the verge of a complete breakdown. Looking back I would describe like this. Normal sleep provides you with something of an emotional / mental "buffer" that is pretty well spent by the end of the day. Sleep restores that buffer and the next day is a whole new cycle. Take the buffer away and over many months and years, you feel like you're going Stark Raving Mad. I am very happy to report that since using CPAP successfully, my daily cycle has been restored to well within normal levels.

I have a lot more empathy for my grandfather, who suffered unknowingly with OSA for his entire adult life--no wonder he was a little grumpy sometimes! I can't imagine having lived like that for 50+ years.

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