The People's Perspective on Medicine

Treating Serious Snoring May Ease Depression

When snoring is due to sleep apnea, using CPAP may also help symptoms of depression.

Obstructive sleep apnea affects tens of millions of Americans. In this condition the airway is briefly but repeatedly closed off, leading to gasping or snoring as a way of re-establishing air flow.

Sleep apnea can complicate conditions such as hypertension, heart disease or diabetes. It may affect as many as 5 % of adults, and is especially common among older people and the overweight.

CPAP

There are no medications for sleep apnea, but it is treated with medical devices. Most common is the CPAP machine, providing continuous positive airway pressure (see picture). Some people are treated with a mandibular advancement device, which moves the lower jaw forward to improve breathing through the mouth.

A meta-analysis of 23 studies found that CPAP treatment alleviated symptoms of depression as well as sleep apnea. People who were depressed at the beginning of the study got the most noticeable response.

The studies also found benefit from the mandibular advancement devices, but the response was modest. The investigators suggest that doctors will need more research to select the patients who will benefit most from sleep apnea treatment.

[PLoS Medicine, online Nov. 25, 2014]

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I had “treatment resistant depression” for ten years. I was treated with high doses of about every kind of antidepressant available, including the MAOI class anti-depressants and tricyclics. I even had an ECT consultation. A lot of the ECT doctors also do sleep apnea on the side BECAUSE they know it works as a good adjunct to meds and ECT in severe cases of depression and also in bipolar. The ECT doctor told me he had seen extremely severe cases of depression improve dramatically when even mild sleep apnea was treated with CPAP machines. I did not have ECT, but I did eventually get diagnosed with mild to moderate sleep apnea and put on a CPAP unit.

Not surprisingly, it made my “depression” much better and in particular helped with the fatigue component of my depression. If you have failed traditional psychiatry and psychotherapy, and many have and you have even one iota belief that you might have even mild sleep apnea, get checked out for OSA. It can totally change your world for the better. You might still have to take meds, but your meds may work much better if you also use CPAP. One of the things with CPAP is you have to have good equipment support, and not all CPAPers have good equipment support, so they don’t get a proper mask, and they give up too early. Also, health insurance companies dont like CPAP. It’s expensive for them. Finally, I’ve tried an oral appliance in addition to CPAP, and while it works OK and has fewer side effects, Ive found it is best suited for mild cases of sleep apnea. Leave the moderate to severe cases of sleep apnea to the CPAP machines with a proper mask. Oral appliances have a place but it’s mainly in those mild to borderline cases of sleep apnea (snoring, mild OSA).

I use a nasal strip to prevent snoring and ease breathing. Nasal strips have been a godsend for me, perhaps others could also benefit from such a simple, cost effective solution.

I am surprised you made no comment on the sample size or the unrealistic procedures used in this “study.” I find the study completely unconvincing and even laughable.

Unfortunately, CPAPs (and diagnoses of sleep apnea in general) are also “fashionable” in the medical world, whether you need (or have) them or not.

I went through the whole sleep clinic thing (talk about material for Saturday Night Live!) about ten years back, was prescribed a CPAP, and returned the devilish device to the medical supply company exactly a month later.

CPAPs may help some people, but in my case, strapping a cumbersome, uncomfortable machine (whose noise, however minimal, was another annoyance) to my head was counterproductive in the extreme. All I got from the experience was more sleepless nights and –despite frequent cleaning of the CPAP–a killer sinus infection.

yes it helps but you need to be careful since lung and throught infections are common if you don’t clean the tubes often.

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