Troubled nights might lead to troubled minds. A large national study from Canada has found that middle-aged and older adults at high risk of obstructive sleep apnea (OSA) are significantly more likely to experience depression, psychological distress, and worsening mental health over time. The findings, published in JAMA, draw a clear line between poor sleep and deteriorating emotional well-being—offering new evidence that OSA screening could be just as vital for mental health as it is for heart and metabolic health.
OSA, a common yet underdiagnosed disorder, causes repeated pauses in breathing during sleep. It affects nearly 936 million adults worldwide, but up to 90% remain undetected, often mistaken for fatigue or snoring. To shed light on how sleep-disordered breathing interacts with long-term mental health, researchers analyzed data from the Canadian Longitudinal Study on Aging (CLSA), a nationally representative cohort tracking adults between 45 and 85 years across social, psychological, and physical domains of aging.
The study included over 30,000 participants from baseline (2011–2015) and nearly 28,000 follow-ups through 2018, with an average gap of three years. The team used the well-validated STOP questionnaire—covering snoring, daytime sleepiness, witnessed apnea, and hypertension—to identify individuals at risk of OSA. Anyone with a score of two or more was classified as high risk. Mental health outcomes were determined from a combined measure of depression, psychological distress, physician-diagnosed disorders, or antidepressant use.
At baseline, about 23.5% of participants were at high risk for OSA—rising to 27% by follow-up. Poor mental health affected roughly one-third of the group. After adjusting for sociodemographic factors, lifestyle, and chronic conditions, those at high OSA risk had about 40% higher odds of poor mental health at both measurement points. Notably, among participants who were mentally healthy at the start, those at high OSA risk showed a 20% greater chance of developing poor mental health three years later. Longitudinal models further confirmed a 44% increased likelihood when changes over time were considered.
The researchers conclude that sleep apnea is a potentially modifiable risk factor for declining mental health in older adults. They call for incorporating OSA screening into community and primary care programs to help protect emotional well-being—proving yet again that when it comes to aging gracefully, a healthy mind truly starts with a good night’s sleep.
REFERENCE: Tetyana Kendzerska; Ranjeeta Mallick; Wenshan Li; et al; Obstructive Sleep Apnea Risk and Mental Health Conditions Among Older Canadian Adults in the Canadian Longitudinal Study on Aging; JAMA Netw Open; 2025;8;(12):e2549137. doi:10.1001/jamanetworkopen.2025.49137
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