Prevalence of depression in pediatric patients with diagnosed or at high risk for obstructive sleep apnea: A systematic review with meta-analysis

Lara Pereira; Ellen Song; Cristine M Stefani; Carlos Flores-Mir; Graziela De Luca Canto; Camila Pacheco-Pereira

doi:10.1016/j.smrv.2024.102040

Prevalence of depression in pediatric patients with diagnosed or at high risk for obstructive sleep apnea: A systematic review with meta-analysis

Sleep Med Rev. 2024 Dec 4:80:102040. doi: 10.1016/j.smrv.2024.102040. Online ahead of print.

Authors

Lara Pereira¹, Ellen Song², Cristine M Stefani³, Carlos Flores-Mir⁴, Graziela De Luca Canto⁵, Camila Pacheco-Pereira⁶

Affiliations

¹ Faculty of Psychiatry, McGill University, Canada.
² Faculty of Medicine, University of Ottawa, Canada.
³ Department of Dentistry, University of Brasilia, Brazil.
⁴ Mike Petryk School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.
⁵ Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Brazil.
⁶ Mike Petryk School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada. Electronic address: cppereir@ualberta.ca.

PMID: 39662148
DOI: 10.1016/j.smrv.2024.102040

Abstract

Obstructive sleep apnea (OSA) may increase the risk of depression through various hypothesized mechanisms. Studies regarding this relationship with children are limited. This systematic review aims to assess the prevalence of depression in pediatric patients with OSA. Five electronic databases, grey literature, and reference lists of included studies were systematically searched. Studies reporting the prevalence of depression, as described by the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatric evaluation or other validated screening measures, in children with OSA diagnosed by polysomnography (PSG), or at high risk for OSA based on positive scores on other validated measures were included. The risk of bias was performed using the Joanna Briggs Institute (JBI) Checklist for cross-sectional studies. Six studies from three countries and over 2300 pediatric patients were included. This meta-analysis showed an overall 28 % prevalence of depression among children with OSA or at high risk for OSA, which is almost two-fold higher than among children without OSA (controls). Overall, this meta-analysis suggests that around one out of every four children with or at high risk for OSA could have depression, and one in 10 children if OSA has been confirmed by PSG. Screening of OSA in pediatric patients with symptoms of depression and vice versa, screening of depressive symptoms in children with suspected or confirmed OSA, may be valuable areas of focus for multidisciplinary preventative care to optimize psychiatric treatment.

Keywords: Children; Depression; Meta-analysis; OSA; Obstructive sleep apnea; Paediatric; Systematic review.

Publication types

Review