Longitudinal association of sleep-related breathing disorder and depression
Longitudinal association of sleep-related breathing disorder and depression
复制标题
DOI：
10.1001/archinte.166.16.1709
复制
发表时间：
2006-09-18
影响因子：
--
通讯作者：
Young, Terry
中科院分区：
文献类型：
--
作者：
Peppard, Paul E.;Szklo-Coxe, Mariana;Young, Terry
背景资料：睡眠相关呼吸障碍（SRBD）和抑郁症分别与大量的发病率、损伤和残疾独立相关。临床策略的发展，筛选和管理抑郁症患者SRBD需要阐明之间的关联的2个条件。本人群为基础的流行病学研究评估SRBD作为一个纵向的预测depression.Methods：男性（n=788）和女性（n=620）随机选择的工作人群进行了评估SRBD在实验室多导睡眠图和抑郁症的Zung抑郁量表。大多数参与者都可以获得以4年为间隔进行的多项研究的结果。睡眠相关呼吸障碍的特征是呼吸暂停低通气指数（AHI;每小时事件数）分类：AHI=0，无SRBD; 0 < AHI < 5，最小SRBD; 5 = 15，中度或重度SRBD。抑郁症被定义为Zung量表得分50或更高或使用抗抑郁药。潜在的混杂，相互作用，和中介因素进行了评估，通过临床测量和questionnaire.Results：在纯粹的纵向模型，增加1 SRBD类别（例如，从最小到轻度SRBD）与1.8倍（95%置信区间，1.32.6）增加调整后的抑郁症的发展几率。在调整后的纵向和横向关联模型中，与没有SRBD的参与者相比，抑郁症发展的几率增加了1.6倍（95%置信区间，1.2-2.1）在最小SRBD的参与者中，2.0倍（95%置信区间，1.4-2.9）轻度SRBD的参与者，（95%可信区间，1.7-3.9）。结论：我们对SRBD和抑郁症之间的剂量-反应关系的纵向研究结果提供了与这些条件之间的因果关系一致的证据，并应提高SRBD患者抑郁症的临床怀疑。
Background: Sleep-related breathing disorder (SRBD) and depression have each been independently associated with substantial morbidity, impairment, and disability. The development of clinical strategies for screening and managing depression in patients with SRBD requires elucidation of the association between the 2 conditions. This population-based epidemiological study assesses SRBD as a longitudinal predictor of depression.Methods: Men (n=788) and women (n=620) randomly selected from a working population were evaluated for SRBD by in-laboratory polysomnography and for depression by the Zung depression scale. Results of multiple studies, performed at 4-year intervals, were available for most participants. Sleep-related breathing disorder was characterized by the apnea-hypopnea index (AHI; events per hour) categories: AHI=0, no SRBD; 0 < AHI < 5, minimal SRBD; 5 = 15, moderate or worse SRBD. Depression was defined as a score of 50 or higher on the Zung scale or use of antidepressants. Potential confounding, interacting, and mediating factors were assessed by clinical measurements and questionnaires.Results: In purely longitudinal models, an increase of 1 SRBD category ( eg, from minimal to mild SRBD) was associated with a 1.8-fold (95% confidence interval, 1.32.6) increased adjusted odds for development of depression. In adjusted models combining longitudinal and cross-sectional associations, compared with participants with no SRBD, the odds for development of depression were increased by 1.6-fold ( 95% confidence interval, 1.2-2.1) in participants with minimal SRBD, by 2.0-fold ( 95% confidence interval, 1.4-2.9) in participants with mild SRBD, and by 2.6-fold ( 95% confidence interval, 1.7-3.9) in those with moderate or worse SRBD.Conclusion: Our longitudinal findings of a dose-response association between SRBD and depression provide evidence consistent with a causal link between these conditions and should heighten clinical suspicion of depression in patients with SRBD.