Sleep and Breathing

, Volume 20, Issue 2, pp 447–456 | Cite as

Comorbid depression in obstructive sleep apnea: an under-recognized association

  • Ahmed S. BaHammamEmail author
  • Tetyana Kendzerska
  • Ravi Gupta
  • Chellamuthu Ramasubramanian
  • David N. Neubauer
  • Meera Narasimhan
  • Seithikurippu R. Pandi-Perumal
  • Adam Moscovitch



Obstructive sleep apnea (OSA) and depression may coexist in the same patient. This article aims to review the link between OSA and comorbid depression and critically evaluate the results of studies that assessed the correlation between OSA and depression, the impact of OSA treatment on comorbid depression, and the impact of comorbid depression on continuous positive airway pressure (CPAP) adherence.


An integrative review was conducted on English language studies and reports that assessed the relationship between OSA and depression. Studies were identified by searching PubMed, Web of Science and Google Scholar databases, and reference lists of included studies.


Generally, cross-sectional studies show a higher prevalence of depression among OSA patients with both community and sleep disorder clinic samples. Nevertheless, the relationship between OSA and depression is complicated by the fact that the disorders have overlapping symptoms. Longitudinal studies demonstrate an increased risk of developing depression among people with OSA, as well as an association between OSA severity and the likelihood of developing depression. On the other hand, studies assessing the impact of CPAP therapy on depression among OSA patients report conflicting results. Therefore, it is essential to consider how the disorders affect one another and to understand the clinical consequences of treating each disorder in isolation.


Depression is prevalent among patients with OSA both in the community and in sleep disorder clinics. Clinicians in general should be aware of this significant association and should aim to treat both disorders.


Depression Obstructive sleep apnea CPAP 



This work was supported by a grant from the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ahmed S. BaHammam
    • 1
    Email author
  • Tetyana Kendzerska
    • 2
  • Ravi Gupta
    • 3
  • Chellamuthu Ramasubramanian
    • 4
  • David N. Neubauer
    • 5
  • Meera Narasimhan
    • 6
  • Seithikurippu R. Pandi-Perumal
    • 7
  • Adam Moscovitch
    • 8
  1. 1.The University Sleep Disorders Center, Department of Medicine, College of MedicineKing Saud UniversityRiyadhSaudi Arabia
  2. 2.Institute for Clinical Evaluative ScienceSunnybrook Health Sciences CenterTorontoCanada
  3. 3.Department of Psychiatry & Sleep ClinicHimalayan Institute of Medical SciencesDoiwalaIndia
  4. 4.M.S. Chellamuthu Trust and Research FoundationMaduraiIndia
  5. 5.Department of Psychiatry and Behavioral ScienceJohns Hopkins University School of MedicineBaltimoreUSA
  6. 6.Department of Neuropsychiatry and Behavioral ScienceUniversity of South Carolina School of MedicineColumbiaUSA
  7. 7.Somnogen Canada Inc.TorontoCanada
  8. 8.Sleep and Fatigue InstituteThe University of CalgaryAlbertaCanada

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