J Korean Soc Biol Ther Psychiatry.  2021 Oct;27(3):190-199.

The Impact of Depressive Symptom on Efficacy and Compliance of Positive Airway Pressure in Obstructive Sleep Apnea

• Lee SY
• Kim SH
• Bang YR
• Jang SH
• Bae WY
• Kim Sj

Abstract

Objectives
：The aim of this study was to determine how the efficacy and compliance of positive airway pressure (PAP) varies depending on the depressive symptom with obstructive sleep apnea (OSA).
Methods
：We collected data about baseline Apnea-Hyponea Index (AHI), sleep and mood state and demographic information from 125 obstructive sleep apnea patients prior to the start of positive airway pressure treatment. The Apnea-Hyponea Index and daytime sleepiness were examined as indicators of efficacy of positive airway pressure and daily average usage time and the utilization rate (%) for more than 4 hours were calculated as indicators of compliance of positive airway pressure at the time of 1, 3 or 9 months after the start of positive airway pressure. Repeated-measures ANOVA and linear mixed model (LMM) with adjusting age, body mass index and baseline Insomnia severity index were used for revealing any significant differences between groups over time passed.
Results
：This difference was confirmed at 9 months after starting positive airway pressure, between the two groups and the usage rate for more than 4 hours in depressive group was lower than that in non-depression group (56.2% vs. 67.5%).
Conclusions
：We demonstrated that there would be a difference in the compliance of positive airway pressure among patients with obstructive sleep apnea according to depressive state. Therefore, we suggest evaluating depressive symptoms in patients with obstructive sleep apnea before starting positive airway pressure, to increase the compliance of the positive airway pressure, which is essential to maintain the efficacy of the positive airway pressure.

Keyword

Sleep apnea; Continuous positive airway pressure; Patient Compliance; Depression; Depressive disorder