The relative association of obstructive sleep apnea, obesity and excessive daytime sleepiness with incident depression: a longitudinal, population-based study.
The relative association of obstructive sleep apnea, obesity and excessive daytime sleepiness with incident depression: a longitudinal, population-based study.
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DOI：
10.1038/ijo.2016.87
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发表时间：
2016-09
影响因子：
4.9
通讯作者：
Vgontzas, A. N.
中科院分区：
文献类型：
--
作者：
LaGrotte, C.;Fernandez-Mendoza, J.;Calhoun, S. L.;Liao, D.;Bixler, E. O.;Vgontzas, A. N.
据推测，阻塞性睡眠呼吸暂停（OSA）是抑郁症发展的危险因素。然而，肥胖和白天过度嗜睡 (EDS) 与 OSA 和抑郁症有关。本研究的目的是探讨 OSA、肥胖和 EDS 对抑郁症的相对影响。 7.5 年后，对宾夕法尼亚州立大学成人队列中 1,137 名无抑郁症成年人的代表性随机样本进行了随访。所有受试者在基线时均接受了全面的体检和多导睡眠图（PSG）。 OSA 定义为呼吸暂停/呼吸不足指数 (AHI) ≥ 5，超重定义为体重指数 (BMI) 25-29.9 kg/m2，肥胖定义为 BMI ≥ 30 kg/m2，EDS 定义为中度至重度嗜睡/嗜睡和/或不可抗拒的睡眠发作。超重、肥胖和 EDS 与抑郁症相关，而 OSA 单独则不然。超重与女性抑郁症相关，而肥胖和 EDS 与男女抑郁症相关。超重和肥胖与抑郁症的关联与病前情绪困扰无关，而 EDS 则不然。 20-40 岁女性的 BMI 和 EDS 与抑郁症之间的关联性更强。 EDS 的严重程度可预测 OSA 患者的抑郁事件，而 AHI 或氧饱和度降低则不能预测。超重、肥胖和 EDS 是抑郁症发生的主要预测因素。肥胖可能通过心理生物学机制与抑郁症相关，而 EDS 可能是抑郁症的早期征兆。肥胖应该成为我们预防抑郁症策略的目标。
It is postulated that obstructive sleep apnea (OSA) is a risk factor for the development of depression. However, obesity and excessive daytime sleepiness (EDS) are associated with both OSA and depression. The goal of this study was to examine the relative contribution of OSA, obesity, and EDS to incident depression. A representative random sample of 1,137 adults without depression from the Penn State Adult Cohort was followed-up after 7.5 years. All subjects underwent a full medical examination and polysomnography (PSG) at baseline. OSA was defined as an apnea/hypopnea index (AHI) ≥ 5, overweight as a body mass index (BMI) of 25-29.9 kg/m2, obesity as a BMI ≥ 30 kg/m2, and EDS as moderate-to-severe drowsiness/sleepiness and/or irresistible sleep attacks. Overweight, obesity, and EDS were associated with incident depression, whereas OSA alone was not. Overweight was associated with incident depression in women, while obesity and EDS were associated with incident depression in both genders. The association of overweight and obesity with incident depression was independent of premorbid emotional distress, while that of EDS was not. The association between BMI and EDS with incident depression was stronger in women 20-40 years old. The severity of EDS predicted incident depression in those with OSA, while AHI or oxygen desaturation did not. Overweight, obesity and EDS are the main predictors of incident depression. Obesity may be linked to depression through psychobiological mechanisms, while EDS may be an early sign of depression. Obesity should be a target of our preventative strategies for depression.
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影响因子：
10.6
作者：
Miller, Andrew H.;Maletic, Vladimir;Raison, Charles L.
通讯作者：
Raison, Charles L.
影响因子：
4.8
作者：
Benca, Ruth M.;Peterson, Michael J.
通讯作者：
Peterson, Michael J.
影响因子：
5.6
作者：
Jaussent, Isabelle;Bouyer, Jean;Dauvilliers, Yves
通讯作者：
Dauvilliers, Yves
影响因子：
5.8
作者：
Bixler, EO;Vgontzas, AN;Kales, A
通讯作者：
Kales, A
影响因子：
120.7
作者：
FORD, DE;KAMEROW, DB
通讯作者：
KAMEROW, DB