Does surgery for obstructive sleep apnea improve depression and sleepiness?

Stacey L. Ishman, James R. Benke, Aliza P. Cohen, Matthew J. Stephen, Lisa E. Ishii, Christine G. Gourin

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives/Hypothesis: To determine if surgical intervention for OSA (obstructive sleep apnea), particularly multilevel surgery, decreases depression and sleepiness.

Study Design: Prospective cohort study.

Methods: Chart and prospective outcome database review of patients who underwent surgery from August 2008 through November 2012. Patients were evaluated before and after surgery using the Epworth Sleepiness Scale (ESS), the Beck Depression Index (BDI), and overnight polysomnography.

Results: Forty-four patients (12 females; 32 males) met inclusion criteria. Mean age of participants was 44.0 years (SD, 10.2); mean body mass index was 31.9 (SD, 9.3). The mean preoperative obstructive respiratory disturbance index (RDI) was 35.8 events/hour (SD, 21.9; range, 6.6-94.2), which decreased to 17.1 (SD, 19.5; range, 0.8-78.1; P<0.0001). Mean ESS improved from 10.8 (SD, 4.7) to 6.3 (SD, 3.7; P=0.0001); whereas BDI scores improved from 8.4 (SD, 8.2) to 4.9 (SD, 6.0; P=0.0051). There were 22 (50.0%) patients with excessive daytime sleepiness and 12 (27.3%) patients with depression before surgery. Surgery was associated with resolution of sleepiness in 17 patients (77.3%) and depression in 9 patients (75.0%). In multivariable regression analysis, only change in ESS (P=0.003) and baseline BDI (P<0.001) were associated with improvement in depression. RDI was not significant (P=0.15).

Conclusions: Surgical treatment of OSA, especially multilevel surgery, resulted in significantly reduced depression, with resolution in 75% of patients. Similarly, surgery resulted in significantly reduced sleepiness, with resolution in 77% of patients. Reduction in sleepiness scores, but not OSA severity, was predictive of improvement in depression scores. Further evaluation with a larger sample size and a control group is warranted.

Original languageEnglish (US)
Pages (from-to)2829-2836
Number of pages8
JournalLaryngoscope
Volume124
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Beck Depression Inventory
  • Depression
  • Epworth Sleepiness scale
  • Obstructive sleep apnea
  • Sleepiness
  • Surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

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