Positive airway pressure treatment improved depressive mood in coronary artery disease patients with obstructive sleep apnea, with device use predicting improvement (OR 1.33; 95% CI 1.10-1.61; p=0.003).
RCT (n=493)
Does continuous positive airway pressure treatment improve depressive mood in adults with coronary artery disease and obstructive sleep apnea?
In adults with coronary artery disease and obstructive sleep apnea, CPAP treatment improves depressive mood independent of sleepiness phenotype and other confounding factors.
Effect estimate: OR 1.33 (95% CI 1.10-1.61)
p-value: p=0.003
We explored determinants of depressive mood in adults with coronary artery disease and obstructive sleep apnea and response to positive airway pressure treatment in sleepy and non-sleepy phenotypes. In this secondary analysis of the RICCADSA trial conducted in Sweden, 493 cardiac patients with obstructive sleep apnea (n = 386) or no obstructive sleep apnea (n = 107) with complete Epworth Sleepiness Scale and Zung Self-rating Depression Scale questionnaires were included. Sleepy (Epworth Sleepiness Scale ≥10) versus non-sleepy (Epworth Sleepiness Scale <10) patients with depressive mood (Zung Self-rating Depression Scale score ≥50) were evaluated after 3 and 12 months of positive airway pressure treatment. In all, 133 patients (27.0%) had depressive mood (29.3% of obstructive sleep apnea versus 18.7% of no obstructive sleep apnea; p = 0.029), with a higher percentage among the sleepy phenotype (36.9% versus 24.5%; p = 0.009). In multivariate analysis, depressive mood was significantly associated with female sex, body mass index and Epworth Sleepiness Scale. Among 97 obstructive sleep apnea patients with depressive mood at baseline, there was a significant reduction in the scores at follow-up both in the sleepy and non-sleepy patients allocated to positive airway pressure treatment, whereas no significant changes were observed in the untreated group (p = 0.033). The device use (hr/night) predicted improvement in mood (odds ratio, 1.33; 95% confidence interval, 1.10-1.61; p = 0.003) adjusted for age, female sex, body mass index, left ventricular ejection fraction, apnea-hypopnea index and delta Epworth Sleepiness Scale score. We conclude that obstructive sleep apnea was associated with depressive mood in adults with coronary artery disease. Treatment with positive airway pressure improved mood in both phenotypes, independent of the confounding factors.
Balcan et al. (Wed,) conducted a rct in Coronary artery disease and obstructive sleep apnea (n=493). Positive airway pressure treatment vs. Untreated group was evaluated on Improvement in mood predicted by device use (hr/night) (OR 1.33, 95% CI 1.10-1.61, p=0.003). Positive airway pressure treatment improved depressive mood in coronary artery disease patients with obstructive sleep apnea, with device use predicting improvement (OR 1.33; 95% CI 1.10-1.61; p=0.003).