What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Obstructive Sleep Apnea and Depressive Symptoms (n=4352). Intervention: High risk of Obstructive Sleep Apnea (OSA) vs. Normal or low risk of OSA. Primary outcome: Depressive symptoms (PHQ-9 score) (B = 1.58, p=<0.001).

June 27, 2023Open Access

The risk of obstructive sleep apnea is highly correlated with depressive symptoms among the Korean adults population: results from the 2020 Korea National Health and Nutrition Examination Survey

Q: What are the key findings of this study?

A high risk of obstructive sleep apnea was significantly associated with increased depressive symptoms among Korean adults aged 40 years and older (B = 1.58, p < 0.001).

Q: What does this research mean for the field?

A high risk of obstructive sleep apnea is significantly associated with increased depressive symptoms among Korean adults aged 40 years and older. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

A high risk of obstructive sleep apnea was significantly associated with increased depressive symptoms among Korean adults aged 40 years and older (B = 1.58, p < 0.001).

Study Design

Type

Cross-Sectional (n=4,352)

Structured PICO

Does a high risk of obstructive sleep apnea increase depressive symptoms in Korean adults aged 40 years and older?

Population

4,352 Korean adults aged 40 years and older from the 2020 Korea National Health and Nutrition Examination Survey (KNHANES).

Intervention

High risk of Obstructive Sleep Apnea (OSA) as assessed by the STOP questionnaire (score ≥ 2).

Comparator

Normal or low risk of Obstructive Sleep Apnea (OSA) as assessed by the STOP questionnaire (score 0-1).

Outcome

Depressive symptoms assessed by the Patient Health Questionnaire-9 (PHQ-9).patient reported

A high risk of obstructive sleep apnea is significantly associated with an increased prevalence and severity of depressive symptoms among middle-aged and older Korean adults.

Main Result

Effect estimate: B = 1.58

p-value: p=<0.001

Limitations

Cross-sectional data precludes determining causation due to the possibility of reverse causality.
STOP questionnaires were based on self-reports (except blood pressure), which may be less accurate than clinical examinations.

Abstract

OBJECTIVES: We aimed to examine the association between Obstructive Sleep Apnea (OSA) risk, health behaviors, and depressive symptoms in a representative Korean sample. METHODS: Cross-sectional data from the 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. The sample included 4,352 adults aged 40 years and older. Multiple linear regression analysis was performed to examine the association between OSA risk, health behaviors, and depressive symptoms. RESULTS: In total, 23.1% of the participants reported a high risk of OSA. Of the respondents, 39.8%, 19.0%, 27.2%, and 8.7% reported hypertension, snoring, tiredness, and observed apnea, respectively. The prevalence of moderate-severe depressive symptoms among adults with high-risk OSA was 7.5%. The significant associations between OSA risk and sex with PHQ-9 were shown in univariate linear regression. In the multiple linear regression analysis, the association between high risk of OSA and PHQ-9 showed in total (B = 1.58; P < 0.001), male (B = 1.21; P < 0.001), and female (B = 1.93; P < 0.001). CONCLUSIONS: A high risk of OSA was associated with an increased prevalence of depressive symptoms. Monitoring the risk factors of depressive symptoms, including OSA, or unhealthy behaviors may decrease the mental health issues of middle-aged and older adults.

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