Depression is a common finding in overweight and obese patients trying to lose weight. So is obstructive sleep apnea.

1. Resistant Depression? Screen for Sleep Apnea

2. Introduction Depression is a common finding in overweight and obese patients trying to lose weight. So is obstructive sleep apnea. Unfortunately, the symptoms of sleep apnea can mirror those of major depressive disorder: tiredness and low energy levels, lack of interest and motivation to pursue your favourite activities, trouble with concentration, memory or decision making, and weight gain.

3. Study A paper by Mitsunari Habukawa and colleagues from the Kurume University School of Medicine, Fukuoka, Japan, just published online in Sleep Medicine, reminds us to screen overweight patients who do not respond adequately to antidepressant therapy for sleep apnea. The authors describe 17 patients, who, despite pharmacotherapy for depression, continued having signs of major depressive disorder and were diagnosed with sleep apnea. After two months of CPAP treatment for sleep apnea, their depression scores significantly improved. Notes: http://www.ncbi.nlm.nih.gov/pubmed/20488748

4. Findings Improvement in depression scores paralleled the reduction in sleepiness. The results illustrate that patients with depression, who despite adequate pharmacotherapy continue having residual symptoms, should be screened for sleep apnea and treated if found positive. An important corollary to this is that overweight and obese patients presenting with sleep apnea, should perhaps also be screened for signs of major depression.

5. Excess Weight = Depression Given the close association between excess weight, depression and sleep apnea, it is probably wise to regularly screen all patients presenting for obesity treatments for both conditions. While simply treating depression and/or sleep apnea in people with excess weight is unlikely to result in significant weight loss, when present, both conditions can pose important barriers to successful weight management and must therefore be adequately addressed.

6. About Dr. Arya M. Sharma Dr. Arya M. Sharma, MD/PhD, FRCPC is Professor of Medicine & Chair for Obesity Research and Management at the University of Alberta, Edmonton, Canada. He is also the Medical Director of the Edmonton Capital Health Region’s interdisciplinary Weight Wise Program. Dr. Sharma is also the Scientific Director of the Canadian Obesity Network funded through the federal Networks of Centres Excellence program. Dr. Sharma has authored and co-authored more than 250 scientific articles and has lectured widely on the etiology and management of obesity and related cardiovascular disorders. He sends his informative messages through his blog Dr. Sharma’s Obesity Notes. For more information on Obesity visit; Website: http://www.drsharma.ca/ Facebook: http://www.facebook.com/pages/Dr-Arya-Sharma/115328778486319