Treatment-resistant depression confounds mental health professionals when their patients don't respond, either initially or long-term, to conventional treatments such as medication and therapy.

Now, a new study in the Journal of Psychiatric Research reports that a type of sleep apnea called obstructive sleep apnea (OSA) may be associated with suicidal patients who have major depressive disorder, causing their depression to resist treatment. OSA occurs in approximately 22 million Americans when they temporarily stop breathing during sleep. It happens when the airway is blocked, usually by the tongue collapsing.

In fact, the American Sleep Apnea Association (ASAA) says the word "apnea" means "without breath," and that people may not breathe for seconds, a minute, or even longer many times during the night—and yes, this is often associated with snoring, too. This may sound like no big deal if the breathing starts back up again—but in fact, sleep apnea puts extra stress on your whole body and raises your risk for many serious diseases, like heart attack, glaucoma, diabetes, cancer, and yes, even depression, says the National Heart, Lung, and Blood Institute.

Approximately 17.3 million adults in the United States have experienced at least one major depressive episode. In fact, depression is considered the world's largest health problem, so understanding how to manage it remains a top priority for mental health researchers.

Estimates vary in the medical literature, but it's generally thought that between one-third to one-half of patients with depression may have the "treatment-resistant" type. Treatment-resistant depression in patients is associated with both ideas about suicide and actual attempts.

The Study

The authors of the psychiatric study, led by Vaughn McCall, M.D., M.S., at the Medical College of Georgia at Augusta University, conducted a randomized clinical trial of 125 adults with major depressive disorder. In the beginning, the authors didn't think any recruits had obstructive sleep apnea. Further investigation did reveal that 14% "met diagnostic criteria for OSA," the authors said, adding that daytime sleepiness and insomnia usually associated with OSA didn't predict how severe the condition was in their patients.

Many people don't even know they have sleep apnea. Going forward, the authors suggest that patients with treatment-resistant depression be screened for OSA. So, if you’re struggling with depression, this is something to discuss with your doctor.

Treatment for Sleep Apnea

If you're diagnosed with sleep apnea, it’s important to take steps to treat it right away to lower your risks of other serious illnesses, including depression. The ASAA recommends these treatments: