Cardiopulmonary Coupling Analysis Predicts Early Treatment Response In Depressed Patients:A Pilot Study

BackgroundMajor depressive disorder(MDD)is a major contributor to the global burden of disease,with severe adverse effects on patients and their families.However,antidepressant drugs have slow effects,low initial response rate and no reliable biological indicators to predict antidepressant treatment response.Sleep disorders are one of the most common symptoms of depression,and cardiopulmonary coupling(CPC)analysis is a new portable sleep assessment method that can quantitatively assess sleep quality.ObjectivesTo evaluate the subjective sleep quality,objective sleep quality(using CPC analysis),depression symptom severity,and the correlation between CPC analysis results and antidepressant treatment effects in MDD patients before and after antidepressant treatment,and to explore CPC analysis indicators that can predict early depression treatment response.MethodsA total of 41 patients with clinical MDD who met the inclusion criteria and exclusion criteria were included in this study.Demographic data including age,gender,years of education,BMI,family history of mental illness,recurrence,course of disease,and types of antidepressants were collected,as well as sleep indicators monitored by CPC analysis,subjective sleep questionnaire and Hamilton Depression Scale(HAMD).Finally,according to the collected data and monitored results,SPSS23.0 was used for statistical analysis.Results1.A total of 41 patients with depression were included,with a gender ratio of 0.43:1(male/female),an average age of 49.8±14.2 years,and an average course of illness of55.6±66.0 months.2.The results of this study showed that after 2 weeks of antidepressant treatment,the unstable sleep time,total sleep time,and sleep efficiency detected by CPC analysis(P<0.05)were significantly lower than those before treatment.3.After treatment,the subjective sleep questionnaire results and HAMD results were significantly improved compared with those before treatment(P<0.001).4.The total sleep time in the CPC analysis before treatment was negatively correlated with the reduction of somnipathy score in HAMD 2 weeks after treatment(P=0.036).The number of unstable sleep was negatively correlated with the reduction in retardation factor score of HAMD after 2 weeks of treatment(P=0.005).The number of REM sleep was closely related to the reductions in cognitive(P=0.016)and retardation factor scores(P=0.380),and the total HAMD score(P=0.048)after 2 weeks of treatment.5.The total bed time of CPC analysis after 2 weeks of treatment was positively correlated with the anxiety/somatic factor score deduction(P=0.009),the retardation factor(P=0.042),and the total HAMD score deduction(P=0.020)after 4 weeks of treatment.Total sleep time was positively correlated with anxiety/somatic factor score deduction(P=0.006)and despair factor(P=0.037).The number of unstable sleep was positively correlated with the reduction of despair factor score(P=0.036).Unstable sleep episodes positively correlated with reduction in the despair score(P=0.036).Get-up episodes negatively correlated with the Pittsburgh Sleep Quality Index(PSQI)total score(P=0.012).Get-up time negatively correlated with the PSQI total score(P=0.011).6.The results of multiple Logistic regression analysis showed that the longer total in-bed time before treatment(OR=1.024,95%CI:1.006~1.042),the longer stable sleep latency(OR=1.024,95%CI:1.002~1.047),the more total in-bed time decrease(OR=1.034,95%CI:1.005~1.064),and the more stable sleep latency decrease(OR=1.040,95%CI:1.003~1.078),the higher is the risk of early non-response to antidepressant treatment.7.Patients with shorter total in-bed time(?565min)at baseline were more likely to response to antidepressant treatment(Person?~2=9.784,P=0.002).Conclusions1.The indicators of CPC analysis before treatment were closely related to the improvement of depressive symptoms of patients after 2 weeks of treatment,while the indicators of CPC analysis after 2 weeks of treatment were closely related to the improvement of depressive symptoms of patients after 4 weeks of treatment.2.Total in-bed time and stable sleep latency in CPC analysis were associated with antidepressant treatment response.Patients with less total in-bed time before treatment suggested that they might be more likely to respond to antidepressant therapy,and may be able to predict treatment outcomes in patients with depression.