Depressive Symptoms in Comorbid Obstructive Sleep Apnea and Insomnia: An Integrative Review.
Bomin Jeon, Faith S Luyster, Judith A Callan and 1 others
PMID 33533324WHAT IT FOUND
Patients with obstructive sleep apnea who also had insomnia generally reported more depressive symptoms than those with sleep apnea alone.
Adding sleep apnea to insomnia did not consistently worsen mood symptoms.
Key findings
01In six studies, patients with obstructive sleep apnea who also had insomnia had higher levels or rates of depressive symptoms than patients with obstructive sleep apnea alone.
02In five sleep clinic studies, patients with comorbid obstructive sleep apnea and insomnia and patients with insomnia alone had more depressive symptoms than patients with obstructive sleep apnea alone, but comorbid disease did not differ clearly from insomnia alone.
03In three studies of patients with insomnia, adding obstructive sleep apnea did not increase severity of depressive symptoms compared with insomnia alone.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies were observational, not experiments, so they cannot show that comorbid sleep apnea and insomnia cause depressive symptoms or that treating one condition improves the other. Definitions and measurements of insomnia and obstructive sleep apnea varied across studies, which prevented a meta-analysis and made findings hard to combine. None of the observational studies reported sample-size power calculations, and several did not account for potential confounding factors. Samples were often predominantly male, race and ethnicity were often not reported, and sleep clinic participants may have been more likely to have sleep problems than people in community samples. Prevalence estimates for comorbid obstructive sleep apnea and insomnia varied widely across studies.
Declared interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.
The easy way to misread this
Do not conclude that comorbid obstructive sleep apnea and insomnia cause depressive symptoms or that treating one condition will improve the other. The review included observational studies only, so it reports associations at one time point and tested no treatment.