Screenig For Obstructive Sleep Apnea In Patients With Depression And Comparison Between Sleep Structures

BackgroundDepressive disorder and obstructive sleep apnea(OSA)are both common diseases in adult and often accompanied by the presence.As many symptoms of OSA are similar to depression and are not typical in patients with depression.Therefore,OSA are easily ignored by psychiatrists in the diagnosis and treatment of depression patients sometimes,which lead to using full-dosage antidepressants and sedative hypnotics cannot complete remission the symptoms.ObjectivesThe prevalence of OSA in depressive disorder was screened and the differences in sleep structures were assessed,the differences in subjective and objective sleep quality also need to evaluated.The related clinical risk factors were explored to provide further evidences for clinical diagnosis and treatment.MethodsA total of 205 patients with depression were screened who met the inclusion criteria and exclusion criteria in this study.Some datas were collected such as patient’s age,sex,neck circumference,waist circumference,and Hamilton depression scale(HAMD),and clinical symptom datas,comorbidities(hypertension,diabetes,etc.),sleep indicators for PSG monitoring,and morning questionnaires(subjective sleep indicators).Through using a polysomnography monitor for overnight sleep monitoring,according to the results of the PSG and the American Sleep Medicine Association to determine diagnostic criteria for sleep apnea in adults,patients were divided into two groups: depression without OSA group(AHI<5)and depression comorbid OSA group(AHI≥5).Finally,according to thecollected data and monitoring results,SPSS 19.0 was used for statistical analysis.Results1.A total of 205 depression patients were included.The gender ratio was 0.69:1,the average age was(52.14±13.73)years,and the average disease duration was(6.03±7.23)years.The average AHI is 11.09(SD=18.11)2.The results of this study showed that 99 patients with depression had comorbid OSA,accounting for 48.3%(99/205).Men(59.5%)are higher than women(40.4%).The depression comorbid OSA group was greater than non-OSA group in age,body mass index(BMI),neck circumference,waist circumference,and HAMD(P<0.05).There was no significant difference in the course of disease(P>0.05).3.Depression comorbid OSA group had more snoring patients(72.7%),higher incidence of hypertension and diabetes mellitus than non-OSA group(P<0.05),and the proportion of smoking history in men with depression comorbid OSA group(32.0%)was less that non-OSA group(67.0%)(P<0.05).There was no significant difference in other aspects such as clinical symptoms at night and daytime dysfunction,complications,and drinking history(P>0.05).4.A comparison of polysomnographic findings showed that the arousal index of depression patients comorbid with OSA was 16.30±13.52 compared with non-OSA group(11.78±11.23)(P<0.05);there was no statistical difference between the two groups in sleep structure indicators(P>0.05).There was significant difference in sleep-related respiratory events(P<0.01),such as depression comorbid OSA group are higher than non-OSA group in AHI,total number of obstructive apneas,total number of hypoventilation,total number of mixed apneas and total oxygen reduction index,while the lowest oxygen saturation was lower than the non-OSA group.In the case of sleep limb movement events,there was no statistical difference between depression comorbid OSA group and non-OSA group(P>0.05).5.The comparison of subjective and objective sleep status showed that the subjectivetotal number of awakenings in the comorbid OSA group was less than objective and the subjective total sleep time was less than objective(P<0.05),but there was no significant difference in subjective and objective sleep latency(P>0.05).Depression without OSA group had more significant subjective sleep latency than objective,subjective awakening times less than objective,and subjective total sleep time less than objective,and the defferences have significant statistically(P<0.05).The subjective sleep latency of depression comorbid OSA group was less than non-OSA group(P<0.05),but there was no statistical difference between the two groups in terms of objective sleep latency,total number of subjective and objective awakenings,and subjective and objective total sleep time(P>0.05).6.The binary logistic regression multivariate analysis showed that the older(OR=1.05,95%CI:1.02~1.08),male(OR=3.71,95%CI:1.45~9.48),and vocal(OR=0.46,95%CI: 0.22~ 0.95)will increase the risk of comorbid OSA in depression..Conclusions1.The incidence of comorbid OSA in depression patients was 48.3%,male-dominated,with significant demographic characteristics and clinical features..2.Depression patients comorbid with OSA mainly affected sleep respiratory events,but had little effect on sleep continuity,sleep structure,and sleep-legged events.3.The older patients with depression,male sex,and snoring during sleep may increase the risk of comorbid OSA.