Hobzova Milada, Prasko Jan, Vanek Jakub, Ociskova Marie, Genzor Samuel, Holubova Michaela, Grambal Ales, Latalova Klara
Department of Pulmonary Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
Department of Psychiatry, University Hospital Olomouc and Faculty of Medicine and Dentistry,Palacky University Olomouc, Czech Republic.
Neuro Endocrinol Lett. 2017 Oct;38(5):343-352.
Obstructive sleep apnea (OSA), is described as intermittent interruptions or reductions in airflow which are initiated by an incomplete or complete collapse of the upper airways despite respiratory effort. When left untreated, OSA is connected with comorbid conditions, such as cardiovascular and metabolic illnesses.
The PubMed database was used to examine papers published until April 2017 using the subsequent terms: "obstructive sleep apnea" or "obstructive sleep apnoea" and "depression" in successive combination with "CPAP (continuous positive airway pressure)", "therapy", "pharmacotherapy", "psychotherapy", "cognitive behavioral therapy" or "quality of life".
After assessment for the suitability, 126 articles were chosen. The numerous evidence of a connection between OSA and depressive symptoms, as well as depressive disorder, were found. This connection may be directly or indirectly linked due to the participation of some OSA mediators consequences such as obesity, hypertension, and the decreased quality of life. Patients with the comorbid major depression and OSA reported more severe and longer episodes of depression. Nevertheless, the information on the effect of the treatment of OSA using CPAP on the depressive symptoms was limited. Still, the current state of the art suggests that this treatment decreases the severity of the comorbid depressive symptoms.
It is important to evaluate the symptoms of depression in the patients with OSA. On the other side, a psychiatrist should not just treat the depression, as it is also important to screen individuals at high risk of OSA when assessing patients for depressive disorder, especially those with depression resistant to treatment.
阻塞性睡眠呼吸暂停（OSA）被描述为尽管有呼吸努力，但由于上呼吸道不完全或完全塌陷而导致的气流间歇性中断或减少。若不治疗，OSA会引发诸如心血管和代谢疾病等合并症。
使用PubMed数据库检索截至2017年4月发表的论文，检索词依次为：“阻塞性睡眠呼吸暂停”或“阻塞性睡眠窒息”以及“抑郁症”，并相继与“持续气道正压通气（CPAP）”、“治疗”、“药物治疗”、“心理治疗”、“认知行为治疗”或“生活质量”组合。
在评估适用性后，选取了126篇文章。发现了大量关于OSA与抑郁症状以及抑郁症之间关联的证据。这种关联可能直接或间接与某些OSA介导因素的影响有关，如肥胖、高血压和生活质量下降。合并重度抑郁症和OSA的患者报告的抑郁发作更严重且持续时间更长。然而，关于使用CPAP治疗OSA对抑郁症状影响的信息有限。尽管如此，目前的研究表明这种治疗可降低合并的抑郁症状的严重程度。
评估OSA患者的抑郁症状很重要。另一方面，精神科医生不仅要治疗抑郁症，在评估抑郁症患者时，筛查OSA高危个体也很重要，尤其是那些对治疗有抵抗性的抑郁症患者。
