Abstract
Obstructive sleep apnoea (OSA) and depression are common in patients with coronary artery disease (CAD). Excessive daytime sleepiness (EDS) in OSA may contribute to depression, and may play role in response to continuous positive airway pressure (CPAP) treatment.
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.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, OA4966.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018