Elif Yilmaz1, Karim Sedky, David S Bennett. 1. Department of Child and Adolescent Psychiatry, Drexel University College of Medicine, Philadelphia, PA.
Abstract
BACKGROUND: A higher incidence of depressive disorders and symptoms has been suggested among children suffering from obstructive sleep apnea (OSA). Yet, the extent to which OSA is related to increased depression is unclear. OBJECTIVES: To evaluate (a) the relationship between depressive symptoms and OSA in pediatric populations, and (b) the efficacy of adenotonsillectomy (AT) for decreasing depressive symptoms among children with OSA. METHODS: A meta-analysis was conducted to assess the relationship between depressive symptoms and OSA, and the efficacy of AT for decreasing depressive symptoms. Studies reporting depressive symptoms of children with OSA through January 2013 were included. RESULTS: Eleven studies assessed depressive symptoms in both children diagnosed with OSA (n = 894) and a comparison group (n = 1,096). A medium relationship was found between depressive symptoms and OSA (Hedges' g = 0.43, 95% CI: 0.22-0.64; p = 0.0005). Addressing the second question, 9 studies (n = 379 children) examined depressive symptoms pre- and post-AT. A medium improvement in depressive symptoms was found at follow-up (Hedge's g = 0.41, 95% CI: 0.20-0.62; p ≤ 0.001). CONCLUSION: Our findings suggest that depressive symptoms are higher among children with OSA. Therefore, patients with depressive symptomatology should receive screening for sleep disordered breathing. Treatment of OSA with AT might decrease clinical symptoms of depression, reduce pharmacotherapy, improve sleep patterns, and promote better health.
BACKGROUND: A higher incidence of depressive disorders and symptoms has been suggested among children suffering from obstructive sleep apnea (OSA). Yet, the extent to which OSA is related to increased depression is unclear. OBJECTIVES: To evaluate (a) the relationship between depressive symptoms and OSA in pediatric populations, and (b) the efficacy of adenotonsillectomy (AT) for decreasing depressive symptoms among children with OSA. METHODS: A meta-analysis was conducted to assess the relationship between depressive symptoms and OSA, and the efficacy of AT for decreasing depressive symptoms. Studies reporting depressive symptoms of children with OSA through January 2013 were included. RESULTS: Eleven studies assessed depressive symptoms in both children diagnosed with OSA (n = 894) and a comparison group (n = 1,096). A medium relationship was found between depressive symptoms and OSA (Hedges' g = 0.43, 95% CI: 0.22-0.64; p = 0.0005). Addressing the second question, 9 studies (n = 379 children) examined depressive symptoms pre- and post-AT. A medium improvement in depressive symptoms was found at follow-up (Hedge's g = 0.41, 95% CI: 0.20-0.62; p ≤ 0.001). CONCLUSION: Our findings suggest that depressive symptoms are higher among children with OSA. Therefore, patients with depressive symptomatology should receive screening for sleep disordered breathing. Treatment of OSA with AT might decrease clinical symptoms of depression, reduce pharmacotherapy, improve sleep patterns, and promote better health.
Authors: Floriana S Luppino; Leonore M de Wit; Paul F Bouvy; Theo Stijnen; Pim Cuijpers; Brenda W J H Penninx; Frans G Zitman Journal: Arch Gen Psychiatry Date: 2010-03
Authors: Robert S Bourke; Vicki Anderson; Joel S C Yang; Angela R Jackman; Asawari Killedar; Gillian M Nixon; Margot J Davey; Adrian M Walker; John Trinder; Rosemary S C Horne Journal: Sleep Med Date: 2011-02-15 Impact factor: 3.492
Authors: Carol L Rosen; Amy Storfer-Isser; H Gerry Taylor; H Lester Kirchner; Judith L Emancipator; Susan Redline Journal: Pediatrics Date: 2004-12 Impact factor: 7.124
Authors: Jin Ye; Yuan Li; Hui Liu; Xian Liu; Xiaowen Zhang; Zhenlin Wang; Zhaotong Huang Journal: Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Date: 2007-03
Authors: Elise Hodges; Carole L Marcus; Ji Young Kim; Melissa Xanthopoulos; Justine Shults; Bruno Giordani; Dean W Beebe; Carol L Rosen; Ronald D Chervin; Ron B Mitchell; Eliot S Katz; David Gozal; Susan Redline; Lisa Elden; Raanan Arens; Renee Moore; H Gerry Taylor; Jerilynn Radcliffe; Nina H Thomas Journal: Sleep Date: 2018-12-01 Impact factor: 5.849
Authors: Ahmed S BaHammam; Tetyana Kendzerska; Ravi Gupta; Chellamuthu Ramasubramanian; David N Neubauer; Meera Narasimhan; Seithikurippu R Pandi-Perumal; Adam Moscovitch Journal: Sleep Breath Date: 2015-07-09 Impact factor: 2.816
Authors: Sukhpreet K Tamana; Lisa Smithson; Amanda Lau; Jennifer Mariasine; Rochelle Young; Joyce Chikuma; Diana L Lefebvre; Padmaja Subbarao; Allan B Becker; Stuart E Turvey; Malcolm R Sears; Jacqueline Pei; Piush J Mandhane Journal: Sleep Date: 2018-01-01 Impact factor: 5.849
Authors: Kristina Puzino; Elizaveta Bourchtein; Susan L Calhoun; Fan He; Alexandros N Vgontzas; Duanping Liao; Edward O Bixler; Julio Fernandez-Mendoza Journal: J Child Psychol Psychiatry Date: 2021-07-26 Impact factor: 8.265