Depression and obstructive sleep apnea

Depression is a common disorder that exists along with obstructive sleep apnea (OSA). The exact relationship between the two disorders is not known. OSA may contribute to depression due to sleep loss, sleep disruption, and cognitive effects of intermittent low oxygen levels to the brain. Also, weight gain and sleep disruption from depression could exacerbate OSA. Some, but not all of my patients report that their depression gets better with treatment of OSA.

This study is a meta-analysis of research looking at the effects of CPAP and oral appliances on depressive symptoms (as obtained by depression questionnaires) in adults with OSA. The results showed small improvements in depressive symptoms with OSA treatment. The greatest benefit was seen in those patients with the worse depression scores at baseline.

Oral appliances for obstructive sleep apnea lower blood pressure

Oral appliances are a type of mouth guard worn at night when asleep to treat obstructive sleep apnea (OSA). I use them in patients with mild to moderate OSA, and in those with severe OSA but who don't respond to CPAP. OSA is strongly associated with high blood pressure (HTN), and CPAP has been shown to help reduce HTN by treating OSA. There have not been many studies showing that oral appliances reduce blood pressure when used to treat OSA. This paper pooled data from 7 studies that measured blood pressure changes in OSA patients using an oral appliance. The results showed that in those with mild to moderate OSA, an oral appliance modestly improved blood pressure, and results were comparable to CPAP.