WA Centre for Health & Ageing, Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, Australia.
WA Centre for Health & Ageing, Medical School, Faculty of Health & Medical Sciences, University of Western Australia, Perth, Australia.
Maturitas. 2020 Dec;142:45-54. doi: 10.1016/j.maturitas.2020.06.002. Epub 2020 Jun 8.
The present study aimed to review the association between obstructive sleep apnea (OSA) and depression and compare the prevalence of depression among people with and without OSA.
Systematic review and meta-analysis following PRISMA guidelines. We searched for papers published between 1 January 2010 and 20 October 2019 listed on the following databases: Embase, Ovid MEDLINER(R) and PsychINFO. The search terms included a combination of keywords related to sleep apnea and depression. We also completed a manual search of the references listed in the articles retrieved and grouped them according to study design: cross-sectional, case-control and longitudinal. Scale scores were standardised for comparison.
Our search strategy yielded 1158 papers, of which 34 were considered suitable of review and 11 reported data that could be used for meta-analysis. Data from the 6 cross-sectional studies found no compelling evidence of an association between OSA and depression (odds ratio = 1.12, 95 % confidence interval, 95 %CI = 0.78, 1.47), but the meta-analysis of 5 longitudinal studies indicated that people with OSA were at greater risk of developing depression during follow-up than those without OSA (non-specific risk ratio (RR) = 2.18, 95 %CI = 1.47, 2.88), although there was evidence of high study heterogeneity (I = 72.8 %).
The results of this systematic review and meta-analysis of observational studies is consistent with the hypothesis that OSA may increase the risk of depression. Sample characteristics and various methodological issues create uncertainty about the validity and generalizability of these associations.
本研究旨在综述阻塞性睡眠呼吸暂停（OSA）与抑郁之间的关联，并比较 OSA 患者与非 OSA 患者中抑郁的患病率。
根据 PRISMA 指南进行系统综述和荟萃分析。我们检索了 2010 年 1 月 1 日至 2019 年 10 月 20 日期间在以下数据库中发表的论文：Embase、ovid MEDLINER(R) 和 PsychINFO。检索词包括与睡眠呼吸暂停和抑郁相关的关键词组合。我们还对检索到的文章中列出的参考文献进行了手动搜索，并根据研究设计对其进行了分组：横断面研究、病例对照研究和纵向研究。对量表评分进行了标准化以进行比较。
我们的检索策略产生了 1158 篇论文，其中 34 篇被认为适合进行综述，11 篇报告了可用于荟萃分析的数据。6 项横断面研究的数据没有提供强有力的证据表明 OSA 与抑郁之间存在关联（优势比=1.12，95%置信区间，95%CI=0.78，1.47），但 5 项纵向研究的荟萃分析表明，与无 OSA 者相比，OSA 患者在随访期间发生抑郁的风险更高（非特异性风险比（RR）=2.18，95%CI=1.47，2.88），尽管存在高度的研究异质性（I=72.8%）。
本系统评价和荟萃分析观察性研究的结果与 OSA 可能增加抑郁风险的假设一致。样本特征和各种方法学问题使这些关联的有效性和普遍性存在不确定性。
