Depressive symptoms in patients with obstructive sleep apnea: biological mechanistic pathways.
Depressive symptoms in patients with obstructive sleep apnea: biological mechanistic pathways.
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DOI：
10.1007/s10865-017-9869-4
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发表时间：
2017-12
影响因子：
3.1
通讯作者：
Pack, Allan I
中科院分区：
文献类型：
--
作者：
Chirinos, Diana A;Gurubhagavatula, Indira;Broderick, Preston;Chirinos, Julio A;Teff, Karen;Wadden, Thomas;Maislin, Greg;Saif, Hassam;Chittams, Jesse;Cassidy, Caitlin;Hanlon, Alexandra L;Pack, Allan I
This study examined the association between depressive symptoms, as well as depressive symptom dimensions, and three candidate biological pathways linking them to OSA: 1) inflammation; 2) circulating leptin; and (3) intermittent hypoxemia. Participants included 181 obese adults with moderate-to-severe OSA enrolled in the Cardiovascular Consequences of Sleep Apnea (COSA) trial. Depressive symptoms were measured using the Beck Depression Inventory-II (BDI-II). We assessed inflammation using C-reactive protein levels (CRP), circulating leptin by radioimmunoassay using a double antibody/PEG assay, and intermittent hypoxemia by the percentage of sleep time each patient had below 90% oxyhemoglobin saturation. We found no significant associations between BDI-II total or cognitive scores and CRP, leptin, or percentage of sleep time below 90% oxyhemoglobin saturation after controlling for relevant confounding factors. Somatic symptoms, however, were positively associated with percentage of sleep time below 90% saturation (β=0.202, P=0.032), but not with CRP or circulating leptin in adjusted models. Another significant predictor of depressive symptoms included sleep efficiency (βBDI Total =−0.230, P=0.003; βcognitive=−0.173, P=0.030, (βsomatic=−0.255, P=0.001). In patients with moderate-to-severe OSA, intermittent hypoxia may play a role in somatic rather than cognitive or total depressive symptoms.
