Grant: Travel Awards - Institute Community Support

Serotonergic neurotransmission via the hypoglossal nerve plays an important role in the control of upper airway muscle tone and pharyngeal collapsibility during sleep. A limited number of studies have reported reductions in the apnea-hypopnea index following antidepressant intake in people with obstructive sleep apnea. Conversely, it has also been proposed that antidepressant use may actually exacerbate sleep-disordered breathing. Surprisingly little is known about these effects in people with depressive disorders. Therefore, this study assessed the effect of antidepressant use on sleep-related respiratory disturbances in individuals with depressive symptoms referred to a specialised sleep clinic. A retrospective polysomnography database from the sleep clinic of a mental health care facility was screened to identify individuals with a documented history of a unipolar depressive syndrome and current depressive symptoms. A sample of 839 patients meeting these criteria was divided into two groups based on antidepressant medication use at the time of polysomnography. Respiratory disturbance indexes (RDIs) were compared across these groups. After controlling for depression severity, the antidepressant group had a significantly higher RDI than the no-antidepressant group. As opposed to previous findings in non-depressed samples, antidepressant drugs are linked to worse sleep-related breathing disturbances in people with depressive symptoms and sleep complaints. Longitudinal studies are required to ascertain whether antidepressant drugs may interact with the pathophysiology of depression to play a causal role in respiratory abnormalities emerging during sleep. These findings may yield important insights for preventative and treatment strategies for sleep-related breathing disturbances in the context of depression.