When someone is depressed and having suicidal thoughts or their depression treatment just isn't working, their caregivers might want to check to see if they have obstructive sleep apnea, investigators say.
That's true even when these individuals don't seem to fit the usual profile of obstructive sleep apnea, which includes males who are overweight, snore and complain of daytime sleepiness, says Dr. W. Vaughn McCall, chair of the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Augusta University.
"No one is talking about evaluating for obstructive sleep apnea as a potential cause of treatment-resistant depression, which occurs in about 50 percent of patients with major depressive disorder," says McCall, corresponding author of the study in The Journal of Psychiatric Research. Now he hopes they will.
The investigators found clinically relevant disease in 14 percent of 125 adult patients with major depressive disorder, insomnia and suicidal thoughts, even though the sleep-wrecking apnea was an exclusion criterion for the original study.
While more work remains, McCall reasons that the new evidence already suggests that testing for obstructive sleep apnea should be part of the guidelines for managing treatment resistant depression.
"We were completely caught by surprise that people did not fit the picture of what obstructive sleep apnea is supposed to look like," says McCall.