Snoring, Sleep Apnea and Depression: Can CPAP Therapy Help?
Depression is one of the most common disorders in the U.S. In any given year approximately 16 million people will experience at least one episode of major depression. And those with a sleep disorder are at a much higher risk of developing depression and having it become a chronic condition. But there is hope. We are going to explore the connection between snoring, sleep apnea and depression and how CPAP therapy can help.
Depression and Depressive Disorders
Everyone experiences feelings of being “down in the dumps” occasionally, it’s a normal and expected part of the human experience. This type of “normal” depression doesn’t last long. Its effects on behavior are short lived and it resolves on its own over time. The problem arises when the depressive episodes last longer than a few days. Trigger major mood, physical or cognitive changes, or impair our ability to function. The first thing to do is call your doctor for a diagnosis.
Types of Depression
Major Depression – Sometimes referred to as “major depressive disorder”. It is characterized by feeling depressed most days of the week. Other symptoms include:
- Loss of interest or pleasure in your activities
- Weight loss or gain
- Trouble getting to sleep or feeling sleepy during the day
- Feelings restless and agitated, or else very sluggish and slowed down physically or mentally
- Being tired and without energy
- Feeling worthless or guilty
- Trouble concentrating or making decisions
- Thoughts of suicide
Feeling depressed along with these other symptoms for a period of two weeks or longer can be an indication of major depression.
Persistent Depressive Disorder – If your symptoms last for two years or longer, it’s called persistent depressive disorder. This use to be called dysthymia or chronic major depression. Other symptoms include:
- Change in your appetite (not eating enough or overeating)
- Sleep too much or too little
- Lack of energy, or fatigue
- Low self-esteem
- Trouble concentrating or making decisions
- Feel hopeless
Individuals with persistent depressive disorder often maintain a negative view of themselves, their future, others around them, and general life events.
Bipolar Disorder – Also known as manic depressive disorder is a condition in which a person’s mood swings from extremely high to extremely low. These low points are a depressive state.
There are several types of bipolar and related disorders. They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.
- Bipolar I disorder. You’ve had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
- Bipolar II disorder. You’ve had at least one major depressive episode and at least one hypomanic episode, but you’ve never had a manic episode.
- Cyclothymic disorder. You’ve had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
- Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing’s disease, multiple sclerosis or stroke.
Seasonal Affective Disorder (SAD) – Seasonal affective disorder is a depression that normally occurs in the winter months. It is thought that this is due to the shorter shorter days which provide less sunlight.
Signs and symptoms of SAD may include:
- Feeling depressed most of the day, nearly every day
- Losing interest in activities you once enjoyed
- Having low energy
- Having problems with sleeping
- Experiencing changes in your appetite or weight
- Feeling sluggish or agitated
- Having difficulty concentrating
- Feeling hopeless, worthless or guilty
- Having frequent thoughts of death or suicide
Often the treatment for SAD will include the use of UV light therapy.
Psychotic Depression – People with psychotic depression have the symptoms of major depression along with “psychotic” symptoms, such as:
- Hallucinations (seeing or hearing things that aren’t there)
- Delusions (false beliefs)
- Paranoia (wrongly believing that others are trying to harm you)
A combination of antidepressant and antipsychotic drugs can treat psychotic depression. ECT may also be an option.
Peripartum (Postpartum) Depression – Woman who have major depression after childbirth may have postpartum depression. The cause is thought to be from the changes in hormones that take place after childbirth. As it’s symptoms can range from mild to severe, medical treatments are advised.
Premenstrual Dysphoric Disorder (PMDD) – Women with PMDD have depression and other symptoms at the start of their period.
Besides feeling depressed, you may also have:
- Mood swings
- Trouble concentrating
- Change in appetite or sleep habits
- Feelings of being overwhelmed
Snoring, Sleep Apnea and Depression: The Link
The link between sleep apnea and depression has been well known for awhile now. However, the conventional wisdom was that depression was the cause of the sleep disorder. Therefore treatments focused mainly on the depression which made the sleep disturbances a low priority.
Thankfully this is starting to change as the link between snoring, sleep apnea and depression is better understood.
It comes as a surprize to no one that sleep deprivation affects mood. Ask any parent of a overtired toddler about it! Lack of sleep makes us cranky and short tempered. It also causes us to be more sensitive to outside stimulus. Things that normally wouldn’t bother us like noise, light and touch become magnified and almost unbearable when we’ve been sleep deprived.
Now add depression into the mix and you have all the ingredients for a downward spiral.
Sleep disturbances, specifically snoring, sleep apnea and insomnia all contribute to depression by making the following symptoms worse:
- Mood swings
- Trouble concentrating
- Feelings of being overwhelmed
Changes in sleep habits can worsen the effects of depression and depression can worsen sleep disorders.
Although there is still debate as to whether sleep disturbances cause depression or are a symptom of it. The evidence is pretty clear that you can at least improve the symptoms of depression by treating sleep disorders.
Snoring Sleep Apnea and Depression: Treatments and Relief
Just a note here, depression is a serious and potentially life threatening condition. If you suspect you may have it please talk to your doctor immediately. Most of the time it is a highly treatable condition that you don’t need to suffer from.
The treatment options for depression are best assessed by your doctor and they can include:
Or any combination of the above.
Snoring, Sleep Apnea and Depression: How CPAP Therapy Can Help
Earlier we talked about how sleep disturbances exacerbate the symptoms of depression, but what can we do about it?
The issue with snoring sleep apnea and depression is that these sleep disturbances interrupt the normal sleep cycle. This prevents us from getting the full restorative benefits of a good night’s sleep.
Snoring occurs when the airway becomes partially blocked by excess tissue in the mouth nose or throat. As air passes through this partially blocked airway it causes the tissue to vibrate creating the noise we call snoring.
Because the airways are partially blocked, snorers struggle to get enough oxygen in their lungs. This can lead to low blood oxygen levels, an increased workload on the heart and high blood pressure.
Snoring can also interrupt REM sleep (the deepest sleep), thus worsening the symptoms of depression.
The good news is that the treatments for snoring have come a long way, are relatively inexpensive and do not require a doctor’s prescription. Some good anti-snoring options include:
- Anti-Snoring Mouthpiece
- Smart Nora Anti-Snoring Device
- Anti Snore Pillow
- Essential Oils
- Anti-Snore Nose Vents
- Zz Snore Spray
- Adjustable Beds
Sleep apnea is snoring’s evil doppelganger! With sleep apnea, the airways become completely blocked. Breathing stops completely cutting off oxygen to the body.
The result is that a person wakes up several (even hundreds) of times a night gasping for air. Episodes of apnea can happen at anytime, but are most frequent in the REM stage of sleep.
Even though suffers often don’t remember waking up hundreds of times, it’s still happening and interrupting their sleep cycle.
This is a very dangerous condition as there is no guarantee that you will start breathing again on your own! It also causes a lack of oxygen to all your vital organs which over the long term can cause them to fail.
Sleep apnea is a serious medical condition that needs to be properly diagnosed and treated by a medical professional. But, once diagnosed, most of the time sleep apnea can be treated very effectively.
Treatments for Sleep Apnea:
There are three basic types of sleep apnea, obstructive sleep apnea OSA, central sleep apnea CSA and complex sleep apnea CSA.
Obstructive sleep apnea is by far the most common. It occurs when excess tissue in the mouth nose or throat completely blocks the airway cutting off oxygen to the lungs. OSA can be caused my many things including having a large tongue or tonsils, enlarged adenoids and excess adipose (fat) tissue in the neck.
Central sleep apnea is less common and is not associated with any obstruction blocking the airway. Instead it seem to be a neurological issue where the part of the brain that controls breathing gets interrupted and the signal to breath isn’t sent (or recieved).
Complex sleep apnea is the rarest form and it is simply a combination of OSA and CSA.
As far as treatments go, no matter what the cause, CPAP therapy is the gold standard. CPAP stands for Continuous Positive Airway Pressure. It’s basically a machine that pumps a continuous stream of air through the mouth and/or nose that keeps the airway open.
This enables suffers to enjoy a full nights sleep without waking up gasping for air hundreds of times a night. CPAP therapy essentially allows people with sleep apnea to experience the full sleep cycle uninterrupted.
CPAP Sleep Apnea and Depression, Promising Results
It is estimated that 22 million Americans suffer from sleep apnea, and 80% of mild to moderate cases go undiagnosed and untreated. Furthermore, in one study:
Sleep apnea was diagnosed in 293 participants, of whom 213 (73%) had symptoms of depression at study baseline. The greater the severity of sleep apnea, the higher the likelihood of depressive symptoms, the researchers found.https://www.medicalnewstoday.com/articles/299905.php
The study went on to say:
The researchers found that the 228 participants with sleep apnea who adhered to CPAP therapy experienced a significant reduction in depressive symptoms after 3 months; once treatment ceased, only 9 (4%) of these participants had clinically significant symptoms of depression.https://www.medicalnewstoday.com/articles/299905.php
What is more, the team found that of the 41 participants with sleep apnea who reported feelings of self-harm or suicidal thoughts at study baseline, none reported any such feelings after 3 months of CPAP.
So what can we take from all of this? Well it’s still an open question as to whether depression causes sleep disturbances or sleep disturbances cause depression. But I’m betting on a recipiral relationship.
But one thing is clear, by treating snoring, sleep apnea and other sleep disturbances, the symptoms of depression can be lessened. And considering how easy it is to treat snoring and sleep apnea you could find significant relief from depression through CPAP therapy.
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