Ong Jason C, Gress Jenna L, San Pedro-Salcedo Melanie G, Manber Rachel
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
J Psychosom Res. 2009 Aug;67(2):135-41. doi: 10.1016/j.jpsychores.2009.03.011. Epub 2009 Apr 25.
Disturbances in sleep continuity are common among individuals with major depressive disorder (MDD) and can impact the course of depression and response to treatment. Several studies have examined depressive symptom severity among sleep-disordered patients with obstructive sleep apnea (OSA). In contrast, little is known about OSA in patients with MDD. The goal of this study was to examine the frequency and predictors of OSA in a sample of individuals with comorbid MDD and insomnia.
Participants were 51 individuals who enrolled in a treatment study on insomnia and depression, met criteria for MDD and comorbid insomnia, and underwent an overnight polysomnography evaluation. An apnea-hypopnea index >or=15 events per hour was used as a cutoff score for OSA. Regression analyses were conducted to examine clinical and demographic predictors of OSA severity as measured by the apnea-hypopnea index.
The results revealed that 39% of the sample met criteria for OSA. The OSA group had significantly higher body mass index (BMI) scores and a significantly greater proportion of men. Regression analysis revealed that male sex, older age, and higher BMI were significant predictors of OSA severity. Neither depression severity nor insomnia severity was a significant predictor.
These findings indicate that the frequency of OSA is higher among individuals with comorbid MDD and insomnia than was previously found among people with either MDD or insomnia alone. In addition, previously identified predictors of OSA (male sex, older age, and high BMI) also apply to this population.
睡眠连续性障碍在重度抑郁症（MDD）患者中很常见，并且会影响抑郁症的病程及对治疗的反应。多项研究已对患有阻塞性睡眠呼吸暂停（OSA）的睡眠障碍患者的抑郁症状严重程度进行了检查。相比之下，对于MDD患者中的OSA情况却知之甚少。本研究的目的是在患有共病性MDD和失眠症的个体样本中检查OSA的发生率及预测因素。
参与者为51名参加失眠与抑郁症治疗研究的个体，他们符合MDD和共病性失眠症的标准，并接受了整夜多导睡眠图评估。呼吸暂停低通气指数≥每小时15次事件被用作OSA的临界值。进行回归分析以检查由呼吸暂停低通气指数衡量的OSA严重程度的临床和人口统计学预测因素。
结果显示，39%的样本符合OSA标准。OSA组的体重指数（BMI）得分显著更高，男性比例也显著更高。回归分析显示，男性、年龄较大和BMI较高是OSA严重程度的显著预测因素。抑郁严重程度和失眠严重程度均不是显著的预测因素。
这些发现表明，共病性MDD和失眠症患者中OSA的发生率高于之前在单纯患有MDD或失眠症的人群中发现的发生率。此外，先前确定的OSA预测因素（男性、年龄较大和高BMI）也适用于该人群。
