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阻塞性睡眠呼吸暂停持续气道正压通气治疗后抑郁症状的变化

Changes in depressive symptoms after continuous positive airway pressure treatment for obstructive sleep apnea.

作者信息

Means Melanie K, Lichstein Kenneth L, Edinger Jack D, Taylor Daniel J, Durrence H Heith, Husain Aatif M, Aguillard R Neal, Radtke Rodney A

机构信息

Psychology Service, Department of Veterans Affairs Medical Center, Durham, North Carolina 27705, USA.

出版信息

Sleep Breath. 2003 Mar;7(1):31-42. doi: 10.1007/s11325-003-0031-x.

Abstract

It is generally believed that obstructive sleep apnea (OSA) causes depression in some patients, yet it is unknown whether this depression is an actual clinical phenomenon or purely a result of overlapping somatic/physical symptoms shared by both disorders. The present study investigated changes in both somatic and affective/cognitive symptoms of depression associated with the introduction of continuous positive airway pressure (CPAP) treatment for OSA. Participants were 39 outpatients (35 males, 4 females) with no current or past mental health problems, diagnosed with OSA in a hospital sleep disorders clinic. The Beck Depression Inventory (BDI) was administered prior to treatment and again 3 months after CPAP. Total BDI scores improved after CPAP, independent of objectively monitored CPAP compliance rates. Both somatic and affective/ cognitive symptoms of depression improved in a similar manner after treatment. Our findings suggest that depressive symptoms experienced by OSA patients are not solely the result of physical OSA symptoms but include a mood component as well. We introduce a hypothetical model to conceptualize the relationship between OSA and depression.

摘要

一般认为,阻塞性睡眠呼吸暂停(OSA)会导致部分患者出现抑郁,然而,这种抑郁是一种实际的临床现象,还是仅仅是两种疾病共有的躯体/身体症状重叠的结果,目前尚不清楚。本研究调查了与采用持续气道正压通气(CPAP)治疗OSA相关的抑郁的躯体症状和情感/认知症状的变化。研究对象为39名门诊患者(35名男性,4名女性),他们目前或既往均无心理健康问题,在一家医院的睡眠障碍门诊被诊断为OSA。在治疗前及CPAP治疗3个月后再次进行贝克抑郁量表(BDI)测试。CPAP治疗后BDI总分有所改善,且与客观监测的CPAP依从率无关。治疗后,抑郁的躯体症状和情感/认知症状均以相似的方式得到改善。我们的研究结果表明,OSA患者经历的抑郁症状并非仅仅是OSA躯体症状的结果,还包括情绪成分。我们引入了一个假设模型来概念化OSA与抑郁之间的关系。

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