Depression and response to CPAP treatment in coronary artery disease patients with sleepy vs nonsleepy obstructive slee apnoea

This study was a secondary analysis of the RICCADSA trial, conducted in Sweden between 2005 and 2013. For the current protocol, 229 CAD patients with OSA (apnoea-hypopnoea index ≥15/h) on cardiorespiratory polygraphy, who had answered Epworth Sleepiness Scale (ESS) and Zung Self-Rating Depression Scale (SDS) questionnaires at baseline and after one-year, were included. Patients with nonsleepy OSA (ESS <10), who were randomized to CPAP (n=101), and those with sleepy OSA (ESS ≥10) who received CPAP (n=128) were compared at baseline and after 1-year. Zung SDS score (range 20-100) of at least 50 was defined as depression (50-59 mild, 60-69 moderate, and ≥70 severe depression).Zung SDS scores were similar at baseline with similar proportion of depression (79.7% in nonsleepy vs 83.0% in sleepy OSA; n.s). After CPAP treatment, 32.4% of the nonsleepy patients, and 31.1% of the sleepy individuals were improved (n.s). In a multivariate logistic regression analysis, CPAP hours/night in the nonsleepy group (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.1-1.7; p=0.007), and, decline in the ESS scores in the sleepy group (OR 1.2, 95% CI 1.0-1.4; p=0.022) were associated with improvement in mood.We conclude that increased CPAP use may improve depression in CAD patients with nonsleepy OSA whereas such a benefit seems to be dependent on improvement in EDS in the sleepy phenotype.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research