Obstructive Sleep Apnea Risk and Mental Health Conditions Among Older Canadian Adults in the Canadian Longitudinal Study on Aging.

High risk of OSA was associated with approximately 40% higher odds of the composite poor mental health outcome concurrently at baseline.

• Adjusted odds ratio at baseline: OR 1.39 (95% CI, 1.28-1.50)
• 7,066 of 30,097 individuals (23.5%) were at high risk of OSA at baseline
• Composite mental health outcome was identified in 10,334 of 30,097 individuals (34.3%) at baseline
• High OSA risk was defined as a STOP questionnaire score ≥2 (snoring, daytime somnolence, witnessed apnea, or hypertension)
• Analysis used multivariate conventional logistic regression with adjustment for confounders

High risk of OSA was associated with approximately 40% higher odds of the composite poor mental health outcome at follow-up.

• Adjusted odds ratio at follow-up: OR 1.40 (95% CI, 1.30-1.50)
• 7,493 of 27,765 individuals (27.0%) were at high risk of OSA at follow-up
• Composite mental health outcome was identified in 8,851 of 27,765 individuals (31.9%) at follow-up
• Median follow-up was 2.9 years (IQR, 2.8-3.1 years)
• Follow-up data came from CLSA Follow-up 1 (2015-2018)

In a repeated-measures analysis, OSA risk remained associated with a 44% higher odds of the composite poor mental health outcome.

• Repeated-measures adjusted OR: 1.44 (95% CI, 1.34-1.53)
• Mixed logistic regression was used for the repeated-measures analysis
• This analysis incorporated data from both baseline and follow-up time points
• The association was consistent across cross-sectional and longitudinal analyses

The study included a large national community-based cohort of 30,097 middle-aged and older adults at baseline with a median age of 62 years.

• Baseline sample: 30,097 individuals; median age 62 years (IQR, 54-71 years); 50.9% women
• Follow-up sample: 27,765 individuals; median age 65 years (IQR, 57-73 years); 50.9% women
• Participants were aged 45 to 85 years at baseline
• Data were drawn from the Canadian Longitudinal Study on Aging (CLSA) Baseline Comprehensive Cohort (2011-2015) and Follow-up 1 (2015-2018)
• Statistical analysis was performed in October 2024

The composite poor mental health outcome was defined by the presence of any of four components: depression scale score, psychological distress scale score, physician-diagnosed mental health condition, or antidepressant use.

• Component 1: Center for Epidemiologic Studies Short Depression Scale score ≥10
• Component 2: Kessler Psychological Distress Scale score ≥20
• Component 3: self-reported physician-diagnosed mental health condition
• Component 4: self-reported antidepressant use
• The composite outcome was computed as a binary variable defined by the presence of any one of these four criteria