Sleep-disordered Breathing in Major Depressive Disorder

Symptoms of major depression and obstructive sleep apnea can overlap in many patients. The question that always arises is: Which comes first? Or are they two separate conditions that just happen to co-exist a lot? This interesting study looked 31 patients who had a formal depression diagnosis but were screened out for obstructive sleep apnea. Compared to healthy controls, these patients had significantly higher rates of flow limitation, which is a milder form of partial breathing obstruction that doesn’t qualify to be classified as an apnea or hypopnea. Flow limitation describes flattening of the nasal airflow tracings, which is associated with interrupted and poor quality sleep. Overall, patients with major depression were 5.86 times more likely to have a diagnosis of obstructive sleep apnea. Interestingly, all the patients that were screened out for significant obstructive sleep apnea also had a depression diagnosis. 

What this paper suggests is that milder forms of sleep-related breathing disorders may contribute to symptoms of major depression. The study authors didn’t treat these patents with flow limitations, but sleep doctors will tell you that by normalizing these flow limitations, sleep quality can be significantly improved. Clinically, I see depression symptoms improve often after using CPAP or dental appliances, even if they don’t have obstructive sleep apnea but have narrowed upper airway passageways.

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3 thoughts on “Sleep-disordered Breathing in Major Depressive Disorder

  1. Dear Dr.Park,

    I have a proposal for you.

    What does it take for the medical community to just look at how the body works rather than symptomatic statistics. Please, read this article I wrote this past January that I have posted on my website at: You will likely need to copy and paste it! Then see if you are interested in co-writing with me a best seller book. That reveals the missing link between dentistry and medicine that runs our body, which is missing yet in plain sight of the scientific community and has us functioning in a fantasy that has us locked in the repair, replace, relieve cycle never revealing the root cause. Here is the link to the article from this past March: You can find my articles on my website under the side bar option of Articles, Sleep Apnea.

    I believe that it takes complete public revelation of this as institutions are too intrenched to acknowledge this, it may be too embarrassing. A carefully crafted book that is humorous, uplifting and dismisses any blame, exposing it can make it safe for all to jump on the band wagon and bring science into all of this in that we learn how the body really functions and integrates and learn how to apply this knowledge.

    Given our advances in technology, we may better study the numerous inter-actions that can occur and determine what is really happening in each individual, which I believe begins with the anatomy.


    Arthur M. Strauss, DDS


    please excuse any grammatical errors or typos

  2. I am just blown away with your advice and doctor Strauss. I have had insomnia for quite a long time,and wear upper dentures. I started getting very sick with headaches,major depression and anxiety and all my medical test(neurology) have come back normal. I have been almost suicidal,as I couldn’t get a diagnoses and have been disabled with head pain. Now,that I think back,I had my back tooth pulled and I think it has thrown my bite off,since I don’t have many chewing surfaces. This connection is amazing. If this could be a cure for my ongoing headaches,depression and head fog,it would be wonderful. Now to find a good doctor in Iowa that knows this information. Thanks again,Susan Brown