Depression with obstructive sleep apnea lead to high cardiovascular disease morbidity/all‐cause mortality: Findings from the SHHS cohort
Depression with obstructive sleep apnea lead to high cardiovascular disease morbidity/all‐cause mortality: Findings from the SHHS cohort
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DOI：
10.1111/jsr.13828
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发表时间：
2023-02
影响因子：
4.4
通讯作者：
Hui Liu;Wan-da Peng;Lin Zhou;Y. Shen;Bin Xu;Jun Xie;Tingting Cai;Jun Zhou;Chong Li
中科院分区：
文献类型：
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作者：
Hui Liu;Wan-da Peng;Lin Zhou;Y. Shen;Bin Xu;Jun Xie;Tingting Cai;Jun Zhou;Chong Li
本研究的目的是利用睡眠心脏健康研究数据，探讨抑郁症、阻塞性睡眠呼吸暂停和心血管疾病发病率/全因死亡率之间的关系。这项前瞻性研究的事后分析使用了1995年至1998年间进行的睡眠心脏健康研究的患者数据。使用多变量Cox比例风险模型探讨抑郁症和阻塞性睡眠呼吸暂停以及心血管疾病发病率/全因死亡率之间的关系。共纳入4918名参与者，其中656名（13.3%）患有阻塞性睡眠呼吸暂停（阻塞性睡眠呼吸暂停组），1614名（32.8%）患有抑郁症（抑郁症组），482名（9.8%）患有抑郁症和阻塞性睡眠呼吸暂停（抑郁症和阻塞性睡眠呼吸暂停组），2166名（44%）既没有阻塞性睡眠呼吸暂停也没有抑郁症（健康组）。健康组、抑郁组、阻塞性睡眠呼吸暂停组、抑郁组和阻塞性睡眠呼吸暂停组心血管疾病发生率分别为24.5%、31.0%、31.6%和41.7%。与健康参与者相比，抑郁症和阻塞性睡眠呼吸暂停参与者的心血管疾病风险增加，这在阻塞性睡眠呼吸暂停的各种定义中是一致的（呼吸暂停-低通气指数≥10 / hr， 15 / hr, 20 / hr， 30 / hr的风险比分别为1.24[1.06-1.47],1.25[1.05-1.49],1.28[1.06-1.54],1.55[1.22-1.96]）。当阻塞性睡眠呼吸暂停的定义为呼吸暂停-低通气指数≥30时，与健康参与者相比，抑郁症和阻塞性睡眠呼吸暂停参与者的全因死亡风险增加（风险比：1.46；95%置信区间：1.07-1.99）。患有抑郁症和阻塞性睡眠呼吸暂停的参与者可能有更高的心血管疾病风险，而呼吸暂停低通气指数较高的参与者可能有更高的全因死亡率风险。
The aim of this study is to explore the association between depression and obstructive sleep apnea, and cardiovascular disease morbidity/all‐cause mortality using Sleep Heart Health Study data. This post hoc analysis of a prospective study used patient data from the Sleep Heart Health Study conducted between 1995 and 1998. The association between depression and obstructive sleep apnea, and cardiovascular disease morbidity/all‐cause mortality was explored using multivariable Cox proportional hazard models. A total of 4918 participants, 656 (13.3%) with obstructive sleep apnea (obstructive sleep apnea group), 1614 (32.8%) with depression (depression group), 482 (9.8%) with depression and obstructive sleep apnea (depression and obstructive sleep apnea group), and 2166 (44%) with neither obstructive sleep apnea nor depression (health group), were included. The incidence of cardiovascular disease was 24.5%, 31.0%, 31.6% and 41.7% for healthy, depression, obstructive sleep apnea, and depression and obstructive sleep apnea groups, respectively. The risk of cardiovascular disease in depression and obstructive sleep apnea participants was increased compared with that in healthy participants, which was consistent across various definitions of obstructive sleep apnea (hazard ratio [95% confidence interval]: 1.24 [1.06–1.47]; 1.25 [1.05–1.49]; 1.28 [1.06–1.54]; 1.55 [1.22–1.96] for apnea–hypopnea index ≥ 10 per hr, 15 per hr, 20 per hr, 30 per hr, respectively). The risk of all‐cause mortality was increased in the depression and obstructive sleep apnea participants (hazard ratio: 1.46; 95% confidence interval: 1.07–1.99) compared with that in healthy participants when the definition of obstructive sleep apnea was apnea–hypopnea index ≥ 30. Participants with depression and obstructive sleep apnea might be at a greater risk of cardiovascular disease, and those with higher apnea–hypopnea index might be at a greater risk of all‐cause mortality.