Sleep apnea, sleep quality, and depression

Sleep apnea can affect your mood. After one night of poor sleep, you may notice yourself feeling irritable or unhappy. After many nights of poor sleep, this can really add up. But can sleep apnea cause full-blown depressive symptoms, beyond that general “blah” feeling? A recent study set out to examine the relationship between sleep apnea and depressive symptoms so that we may have a better understanding of how sleep apnea affects mood. 

A research study, conducted by researchers in Seoul, Korea, included over 300 people with suspected sleep apnea. These were people who had come to the sleep lab with complaints of snoring, choking while sleeping, or excessive sleepiness. A commonly used depression scale (Beck Depression Scale) was completed by each of these participants prior to an overnight sleep study. In addition, each participant completed a sleep problems scale, which addresses how often they have sleep difficulties. Each subject underwent an overnight sleep study so that the research team could assess the presence and severity of sleep apnea, and statistical analyses examined whether or not those with worse sleep apnea had more depression symptoms.

It was found that, perhaps surprisingly, there was no direct link between sleep apnea and depression. In other words, although it was hypothesized that those with worse sleep apnea would have more depression symptoms, and vise versa, this result was not found. However, when taking into account the other questionnaires that were completed, it was found that there was a mediating factor present. A mediating factor is something that is necessary in order for two other factors to be related. In this case, the mediating factor was a sleep quality score, gauged using one of the questionnaires. Overall, it was found that sleep apnea was a predictor of higher depressive symptoms when the participants had poor self-rated sleep quality.

This is an interesting study, and it is very logical. It seems that sleep apnea and depression are linked but only when poor self-rated sleep is present. Perhaps this means that sleep apnea only really worsens sleep in some people, and these people are the ones who are most affected. An alternative possibility is that depression symptoms are dependent on how we think we slept. If an individual wakes up knowing they had a terrible night of sleep, they might be more likely to be moody and depressive than someone who believes their sleep is just fine. This is all speculation, of course, but everyone will benefit from treating sleep apnea. If there is no apnea, there is no worry about this analysis!

Lee, W., Lee, S. A., Chung, Y. S., & Kim, W. S. (2015). The Relation Between Apnea and Depressive Symptoms in Men with Severe Obstructive Sleep Apnea: Mediational Effects of Sleep Quality. Lung, 1-7.

Janna Mantua


Janna is a PhD Student / Graduate Research Assistant at University of Massachusetts Amherst with a background in clinical sleep research and psychology. Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.

1 Comment

Rita Arnold
Rita Arnold

March 13, 2015

I am in Houston, Texas and currently using another DME as of Jan 2015. How do I switch to your company for addt’l splys and compliance? I am very,very unhappy with my current DME as they have not followed up with me nor ever sent anyone to my home to set up my CPAP but yet sent my unit via UPS to me and referred me to YouTube to learn how to operate it. It has been a horrible experience and I want to get out and away from them without giving them anymore of my business. How does all of this work since they are billing my insurance each month for 13 mos? Thank you for any help you can provide.

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