Uvulopalatopharyngoplasty reduces the incidence of depression caused by obstructive sleep apnea

Objective: To investigate the increase in the incidence of depression in patients with obstructive sleep apnea (OSA) and its preventability by uvulopalatopharyngoplasty (UPPP). Methods: In this retrospective cohort study, data from the Korea National Health Insurance Corporation were analyzed. A total of 160,840 participants (age ≥ 20 years) who were newly diagnosed with OSA between 2007 and 2014 were included. The participants were classified into a group that underwent UPPP (UPPP group, n = 19,773) and a group that did not undergo surgical treatment (no surgery group, n = 141,067). Propensity score matching by age and sex was used to select the control group of 804,200 subjects. The mean follow-up duration was 4.6 ± 2.3 years. The primary endpoint was newly diagnosed depression. Results: The incidence of depression was higher in patients with OSA than in controls (hazard ratio [HR]: 1.678, 95% confidence interval [CI]: 1.650–1.706). The UPPP group was still at a higher risk of depression than was the control group (HR: 1.535, 95% CI: 1.463–1.610), but the HR was statistically lower than that in the no surgery group (HR: 1.694, 95% CI: 1.665–1.724). Conclusion: OSA increases the incidence of depression, which may be prevented to some extent by UPPP. Level of Evidence: 2b Laryngoscope, 129:1005–1009, 2019.