Reminder about corelation of OSA/CA & depression

I recently had an email from someone who commented on feeling depressed and how this seemed to impact their attitude/ability to exercise.

Am wanting to ask for any stories from people here about how their own depression started to lift once they got their therapy under control plus to confirm that as the depression lifts so does the inhibition to exercise etc:

There is a formula that I think explains this ...

1.OSA/CA => 2.Decline in well being => 3. depression => 4. sluggishness & lack of will to exercise => 5. increase in weight => 6. worse OSA/CA => go to 3.

What I believe is worth explaining is that depression is a natural follow component on to undiagnosed/untreated OSA/CA.

Pls add any stories here that can offer hope to those among us trapped in this pattern

Tks

DSM

A quick check of google: Results 1 - 10 of about 25,700 for "Apnea +depression". Lotta links. Here's a press release of a Stanford study linking these 2 conditions: http://www.thefreelibrary.com/Sleep+Apn ... 0109862298

Muse-Inc wrote:A quick check of google: Results 1 - 10 of about 25,700 for "Apnea +depression". Lotta links. Here's a press release of a Stanford study linking these 2 conditions: http://www.thefreelibrary.com/Sleep+Apn ... 0109862298

Muse - excellent links - the 1st byline I saw was this ...

"People with depression are five times more likely to have a breathing-related sleep disorder Sleep disorder
Any condition that interferes with sleep. At least 84 have been identified, according to the American Sleep Disorders Association.

Mentioned in: Insomnia, Night Terrors than non-depressed people, according to a study at the Stanford University School of Medicine Stanford University School of Medicine is affiliated with Stanford University and is located at Stanford University Medical Center in Stanford, California, adjacent to Palo Alto and Menlo Park.

The study is the first to show a link between depression and sleep apnea sleep apnea, episodes of interrupted breathing during sleep. Obstructive sleep apnea is a common disorder in which relaxation of muscles in the throat repeatedly close off the airway during sleep; the person wakes just enough to take a gasping breath."

Tks DSM

I maintain that the great majority of people seeing psychiatrists or psychotherapists and/or taking antidepressants have untreated/undiagnosed SDB as the root cause of their problems. I have collected stories of this happening to friends and professional associates. Currently there are five lady acquaintances I would like to send for sleep studies. All three are taking antidepressants. All three are overweight and have narrow recessed chins. All three look worn and admit to having problems sleeping. Why do people shy away from being diagnosed with sleep apnea? Certainly many of them say, "I could not sleep with a mask."

dsm wrote: There is a formula that I think explains this ...

1.OSA/CA => 2.Decline in well being => 3. depression => 4. sluggishness & lack of will to exercise => 5. increase in weight => 6. worse OSA/CA => go to 3.

What I believe is worth explaining is that depression is a natural follow component on to undiagnosed/untreated OSA/CA.
DSM

I think #2 can be made more specific. OSA related arousals occasion a release of cortisol, and then of course chronic elevated cortisol is thought to be the main culprit that causes the brain damage (you might call it) which eventuates in mood and anxiety disorders across the board.

But the notion of the depression lifting naturally as the chronic stressor is withdrawn is not something to be expected absent treatment. I mean treatment of the depression, not the OSA. I believe current thinking (for what that is worth) is that the normal course of events in untreated depression is recurring episodes, and trending ever worse over time.

Brain_Cloud

Yup that formula could be rearranged & qualified. I was thinking that there could be more steps & perhaps in a slightly different order.

The really important message of course, being that OSA/CA & Depression are brothers (sisters ? - both ? )

Cheers

DSM

Seems to me OSA therapy IS treatment for depression that is caused by OSA. I wonder how one could know if they would have had depression even without OSA, and need to seek additional help? I guess what I'm trying to understand is by what mechanisms does OSA cause depression, and how antidepressants would address those particular mechanisms? I mean, if the depression is caused by adrenaline, how do meds counteract that effect? I confess I don't know much about treatment with meds, other than a few friends have used them for situational depression. I have in times past had a couple bouts with situational depression, but was able to work thru it with the support of people who cared and one time with a counselor.

However, what I went thru at the time of my crisis in 2006 was beyond anything I'd known. I refused to let my doctors persuade me to say I was depressed, even though there were 4 or 5 times I broke down crying in different doctors' office. I confessed my fear that once I got that label no one would pursue the cause for how I felt. I remember trying not to scream as I said, " I'm NOT depressed, I'm SICK!" Somehow I just knew that there was a tangible (though elusive) physical cause for how horrid I felt. I can't help but wonder how often "depression" is actually a bone tired weariness - total depletion of energy. Anyhow, as my limb movements and OSA treatment improved, so did many of the symptoms of depression.

If you ask me now if I'm depressed, I'd say no, even though I still seldom get enthused enough about anything to take some action. Recently read something that caught my attention. Seems dopamine in the brain is associated with pleasure. Since I have RLS/PLMD, thought to be at least in part caused by not enough dopamine, could my mood be a reflection of that?

I fell asleep while typing this a few hours ago, so I'm looking forward to reading the responses of others. Doug, I'm trying to think through the points you've made about your treatment and symptoms. If I think of anything of significance, I'll post again.

Kathy

P.S. Just revisited this and duh, I left out a word that makes a world of difference. Meant to say "your friend's treatment" not yours.

I have been reading about deficiency of vitamin D. Low levels of D are correlated with many things, among which are depression and sleep disorders. You might add that to your formula.

Compared to lifestyles in the past, we currently are inside all day and wear sunscreen while outdoors so don't get the benefit of the sun. Much is written about how the current daily requirements are barely enough to prevent rickets and should be greatly increased. Older people have higher requirements anyway, and so do obese folks. Vitamin D levels in your blood are at the lowest at the end of winter.

A simple blood test could help you find another component to recovery from depression.

Catnapper - Joanie

brain_cloud wrote: I believe current thinking (for what that is worth) is that the normal course of events in untreated depression is recurring episodes, and trending ever worse over time.

However, that "current thinking" is based on studies of populations of patients who had very high prevalence of undiagnosed SDB. I am skeptical as you are and think the "current thinking" is wrong.

As far as brain damage, there are recent studies of untreated apneics using scans that found spiders (lesions) throughout the grey matter. A recent UCLA study found all patients had 20% reduction in size of the two mammillary bodies at the base of the brain stem. The mammillary bodies play key roles in memory and moderation of emotions.

"The reduced size of the mammillary bodies suggests that they've suffered a harmful event resulting in sizable cell loss," Harper said. "The fact that patients' memory problems continue despite treatment for their sleep disorder implies a long-lasting brain injury."

http://newsroom.ucla.edu/portal/ucla/uc ... 51534.aspx

Along with excess levels of cortisol, adrenaline is often created in excess quantities. This can lead to high anxiety and periods of anxiety repeated over a long time can cause depression.

rooster wrote:

brain_cloud wrote: I believe current thinking (for what that is worth) is that the normal course of events in untreated depression is recurring episodes, and trending ever worse over time.

However, that "current thinking" is based on studies of populations of patients who had very high prevalence of undiagnosed SDB. I am skeptical as you are and think the "current thinking" is wrong.

yes and no. Years of living with lack of energy and depression can build habits of thinking that are self fulfilling after your OSA is treated.

I am getting getting therapy to deal with the last 5 years of negative thoughts which have worn a rut in my psyche. I am no longer tired in the evening but I have found it hard to break out of the routine of collapsing onto the couch and watching tv and snacking. When some suggests doing something my mind immediately nixs it because it would be too tiring despite the fact that I can easily work out for an hour after work and spend the rest of the evening sewing.

Catnapper wrote:I have been reading about deficiency of vitamin D. Low levels of D are correlated with many things, among which are depression and sleep disorders. You might add that to your formula.

Great point! Recently My mother and 3 siblings had cadillac, all inclusive blood tests (I was away that visit). All 4 were extremely Vitamin D deficient. I can only assume I am as well. Vitamin D helps you process Calcium, or maybe it's the other way around. Either way, if your deficient in one, you're probably deficient in the other. That means you're depressed and you have back pain!

I take Calcium daily fortified with Vitamin D. That way they work hand in hand. Also, you can treat yourself to these yummies to up your Vitamin D when the sun don't shine:

* Fish liver oils, such as cod liver oil, 1 Tbs. (15 ml) provides 1,360 IU (one IU equals 25 ng)- I recommend taking this in pill form. Take daily. To avoid fishy burps, put the jar of pills in the freezer. Don't know why, but it works like a charm.
* Fatty fish species, such as:
>o Herring, 85 g (3 ounces (oz)) provides 1383 IU
>o Catfish, 85 g (3 oz) provides 425 IU
>o Salmon, cooked, 100 g (3.5 oz]) provides 360 IU
>o Mackerel, cooked, 100 g (3.5 oz]), 345 IU
>o Sardines, canned in oil, drained, 50 g (1.75 oz), 250 IU
>o Tuna, canned in oil, 85 g (3 oz), 200 IU
>o Eel, cooked, 100 g (3.5 oz), 200 IU
* A whole egg, provides 20 IU
* Beef liver, cooked, 100 g (3.5 oz), provides 15 IU
* UV-irradiated mushrooms (Vitamin D2)[28][29]

This topic has been added to the wiki:

wiki/index.php/Depression_and_OSA

It still needs insight and your adds.

I have had extreme anxiety problems that were exacerbated by untreated OSA and also the loss of a child last year, which also threw me into the PTSD realm (the birth was very traumatic, unexpected, at home).

As far as depression, well you can imagine the intense grief I have suffered since last year. However, with CBT therapy, xPAP therapy and time, it has gotten MUCH, MUCH better. It's hard for me to quantify if the xPAP therapy alone was enough to lift my depression, but I'd say it was a definite factor.

There is more importance to it than just brother and sister. Sleep disorders, depression, cardiovascular disease, obesity, diabetes, Alzheimer’s, cancer, and the rest of the list of adult onset degenerative diseases are all part of the same family. And yes, hormonal dysregulation is the family bond that ties them all together.

What I am learning is that it is hormones that are the biochemical switches that interface between environmental stimuli (ie. diet, sleep, exercise, toxins, etc.) and the expression of our genes (health vs. disease states). So yes, recent studies are showing that vitamin D, which is actually a hormone, plays a very important role in our gene expression. Thus, how we eat, sleep, play, and exercise regulates are hormones which in turn keep us healthy and sexually vibrant (yes, sex is the sole purpose of our existence) … or how we die (being removed from the pool of natural selection).

BlackSpinner wrote:........
I am getting getting therapy to deal with the last 5 years of negative thoughts which have worn a rut in my psyche. I am no longer tired in the evening but I have found it hard to break out of the routine of collapsing onto the couch and watching tv and snacking. When some suggests doing something my mind immediately nixs it because it would be too tiring despite the fact that I can easily work out for an hour after work and spend the rest of the evening sewing.

There is another possibility. Exercise can clear out excess hormones caused by apnea treated with an imperfect CPAP therapy (It is almost always imperfect). Exercise could also be releasing enough endorphins to feel energetic enoung to continue exercising and to sewing the rest of the evening. Social activity is not so effective at clearing out excess hormones and releasing endorphins.