Sleep apnea and depression: how they're linked

Sleep apnea and depression often show up together, and each can make the other harder to spot. Both can leave you exhausted, foggy and low, so one is easily mistaken for the other. Studies suggest sleep apnea raises the odds of depression, and treating sleep apnea with CPAP modestly lifts mood for many people. If you're dealing with either, it's worth asking about both.

If you're struggling right now or thinking about suicide, in the US call or text 988 or chat at 988lifeline.org. In a life-threatening emergency, call 911.

Is sleep apnea linked to depression?

Sleep apnea is linked to depression in several kinds of studies. The best known is the Wisconsin Sleep Cohort, reported in 2006 in the Archives of Internal Medicine. Researchers gave 788 men and 620 women overnight sleep tests and depression questionnaires, repeating them about every four years.

The pattern was a dose-response one. Compared with people with no sleep-disordered breathing, the odds of developing depression were 1.6 times higher with minimal sleep-disordered breathing, 2.0 times higher with mild and 2.6 times higher with moderate or worse. The authors said this is consistent with a causal link and should make doctors more alert to depression in people with sleep apnea.

The link shows up from the other direction too. A 2015 systematic review in the Journal of Clinical Sleep Medicine found sleep apnea may be more common in people with major depressive disorder and PTSD, though the studies varied a lot and many had a high risk of bias. A 2026 meta-analysis in Acta Psychiatrica Scandinavica pooled 47 studies and found obstructive sleep apnea in about 38% of people with major depressive disorder. The authors said the pooled figures were largely shaped by studies done in clinics and sleep referral settings, so they're likely higher than in the general population.

Which symptoms do sleep apnea and depression share?

Sleep apnea and depression share several symptoms, which is one reason they get confused. NIMH lists fatigue or lack of energy, difficulty concentrating, remembering or making decisions, and sleep problems, including waking too early or oversleeping, among the symptoms of depression. The NHS lists feeling very tired, finding it hard to concentrate and mood swings among the daytime symptoms of sleep apnoea. The NHLBI adds insomnia and daytime sleepiness.

NIMH says depression is diagnosed when symptoms are present most of the day, nearly every day, for at least two weeks, and one of them must be low mood or loss of interest. It also notes that some medical conditions can cause the same symptoms as depression, and a provider can check for them with an exam, an interview and tests.

The overlap matters in practice. Someone treated for depression whose real problem is untreated sleep apnea may keep feeling tired. And someone with sleep apnea who also has depression may not feel better from CPAP alone. Our guide to why you wake up tired covers other common causes of morning exhaustion.

Can sleep apnea cause depression?

Sleep apnea may help cause depression, but the evidence stops short of proof. The Wisconsin study's dose-response pattern points that way, and so do treatment trials where mood improves with CPAP. But observational studies can't rule out that something else, such as weight, other health problems or poor sleep from other causes, drives both.

What's clearer is that the two conditions often sit together and make each other harder to live with. The 2015 review concluded that when someone has both sleep apnea and a psychiatric condition, treating both should be considered for the best results.

Does CPAP help with depression?

CPAP helps with depression symptoms in many people with sleep apnea, though the effect is usually modest. A 2014 meta-analysis in PLOS Medicine combined 19 randomized trials. CPAP improved depressive symptoms compared with control treatments, but results varied a lot between trials.

The size of the benefit depended on where people started. In the two trials where people had more depression at the start, CPAP produced much larger improvements than in the 15 trials of people who weren't depressed to begin with. The review also found five trials of mandibular advancement devices, the mouthpieces that hold the lower jaw forward, which showed a small improvement in depressive symptoms. The authors said CPAP and these devices may be useful parts of treating depressive symptoms in people with sleep apnea and depression, but that how they compare with standard depression treatment is unknown.

The SAVE trial added more evidence. It was designed to test whether CPAP prevents heart events in people with sleep apnea and heart disease, and while it didn't, the main 2016 results showed CPAP improved mood and quality of life. A 2019 follow-up analysis of 2,410 SAVE participants found CPAP lowered the odds of clinically significant depression symptoms by about 20% compared with usual care, with a bigger effect in people who already had depression symptoms. The same paper's review of 20 trials with 4,255 people confirmed a small benefit on depression. The authors found the benefit was independent of improvements in sleepiness. Neither SAVE nor the review found any effect on anxiety.

So CPAP is worth using well, and our guide to getting used to CPAP can help. It works best as one part of care, not a replacement for depression treatment. NIMH notes that finding the right depression treatment can take some trial and error.

What don't these studies tell us?

These studies leave some real gaps, and it helps to know them before expecting too much from any one treatment. The 2014 PLOS Medicine review pointed out that the depression scales used in the trials haven't been validated specifically in people with sleep apnea. Since those scales ask about tiredness and sleep, some of the improvement could reflect better sleep rather than a change in mood itself.

The people studied also weren't always typical. The SAVE trial enrolled mostly men with moderate to severe sleep apnea, existing heart disease and little daytime sleepiness, and they used CPAP for an average of 3.3 hours a night. The 2015 review of psychiatric conditions found many of its studies had a high risk of bias. And the Wisconsin study measured depression with a questionnaire score or antidepressant use rather than a clinical diagnosis.

None of this undoes the main findings. It's a reason to treat sleep apnea for its own sake and to treat depression directly too, rather than counting on one to fix the other.

Should people with depression be screened for sleep apnea?

People with depression who snore, feel very sleepy or wake up gasping should ask about sleep apnea. The 2026 meta-analysis called for systematic assessment for sleep apnea in psychiatric care, and the Wisconsin researchers urged doctors to watch for depression in people with sleep-disordered breathing.

The NHS says to see a GP if your breathing stops and starts in sleep, you make gasping, snorting or choking noises, or you always feel very tired during the day. A sleep test can often be done at home. Our guides to sleep apnea warning signs and home sleep apnea tests explain what to expect.

It helps to raise both concerns at the same appointment. Tell your doctor about your mood as well as your sleep, and bring a partner's observations about your snoring if you can. Sleep apnea often looks different in women, with more fatigue and insomnia than loud snoring, which our guide to sleep apnea in women explains.

What if you have insomnia too?

Insomnia often comes along with both sleep apnea and depression, which can make the picture more tangled. The NHLBI lists insomnia as a sleep apnea symptom, more common in women, and NIMH lists difficulty sleeping or waking too early as a depression symptom. Our guide to sleep apnea and insomnia covers how the two are treated together.

Where can you get help?

You can get help for depression from your doctor, a mental health professional or a crisis line if things feel urgent. NIMH says that if you or someone you know is struggling or having thoughts of suicide, you can call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org, and that in life-threatening situations you should call 911. Outside the US, contact your local emergency number.

For non-urgent help, a doctor can screen for depression and sleep apnea at the same visit. NIMH says depression treatment usually involves talk therapy, medication or both, with brain stimulation therapy as another option if those don't help enough. It adds that antidepressants usually take 4 to 8 weeks to work, with sleep, appetite and concentration often improving before mood does.

This article is general information, not medical advice. Talk to your doctor or a mental health professional about your own situation.

Read next

• Sleep apnea and insomnia
• Sleep apnea in women: symptoms that get missed
• Sleep apnea and nightmares

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.