Sleep Apnea in a Sample of Patients with Treatment Resistant Depression Referred for Electroconvulsive Therapy

Abstract

Objective: Symptoms of sleep apnea (SA) often overlap with symptoms of depression. Without extensive exploration of a patient's history it is possible that SA could complicate depression leading to treatment resistant depression (TRD) which is then referred for electroconvulsive therapy (ECT). To date no study has reported on prevalence of SA within this population. Materials and Methods: We conducted a retrospective chart review of patients referred for ECT for TRD from 2008 to 2011 (N= 118) at the Central Arkansas Veteran's Healthcare System. Patients were placed into categories of known SA (diagnosed with polysomnography and recorded on chart), high risk SA (suspected SA documented in the chart by a physician), or unknown/low risk SA (negative polysmonography). Results: Average age was 54.5 +/- 12 years. Average body mass index (BMI) was 30.3 +/- 7.3 kg/m(2). 36% had either known SA (27%) or were at high risk of having SA (9%). Those with known SA were more likely to have hypertension (9.4 CI 3-29.5), BMI= 30 kg/m(2) (5.4 CI 2.2-13.5), and hyperlipidemia (4.2 CI 1.6-11.4). Known SA was not significantly associated with diabetes mellitus (2.2 CI 0.8-5.6), complaints of pain (2.4 CI 0.9-5.9), or headache (1.5 CI 0.6-3.8). Conclusion: A diagnosis of SA should be considered in patients referred for ECT for TRD. BMI= 30 kg/m(2), presence of hypertension, and hyperlipidemia are more likely in patients with SA and should raise suspicion of the disorder in patients within this population.