Aftab Zarmeena, Anthony Adarsh Thomas, Rahmat Shermeen, Sangle Prerna, Khan Safeera
Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2021 Jun 24;13(6):e15907. doi: 10.7759/cureus.15907. eCollection 2021 Jun.
Obstructive sleep apnea (OSA) is a common sleep disorder occurring across all age groups, gender, and is multifactorial. The episodic decrease in airflow during sleep results in hypoxia and hypercapnia over time, resulting in morning headache, systemic and pulmonary hypertension, and polycythemia. Fragmentation of sleep at night-time cause daytime somnolence, fatigue, memory problems, and mood symptoms such as depression and anxiety. These secondary mood symptoms could be easily missed by healthcare providers as the primary disorder resulting in unnecessary anti-depressants' prescription. This study investigates the effect of continuous airway pressure (CPAP) on depressive symptoms of OSA. We used PubMed, PubMed Central (PMC), and MEDLINE for data collection. We used OSA, depression, anxiety, mood symptoms, psychological symptoms, and CPAP as the keywords, both alone and in combination. The search ended on November 5, 2020, and it was limited to the year 2010 until the day of the search. However, a few of the papers published earlier than 2010 were also included to have better insight into some aspects of the topic. We included articles measuring the impact of CPAP on mood symptoms using any one of the validated scales, such as the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), Hospital Anxiety and Depression Scale (HADS), or Hamilton Depression Scale (HAM-D). Our initial searches yielded 131 articles. Twenty-one of the 131 papers satisfied the review's criteria. Four studies out of 21 revealed no improvement in OSA-related mood symptoms with CPAP therapy, whereas the others reported beneficial effects on mood, daytime sleepiness, cognition, and patient quality of life.
阻塞性睡眠呼吸暂停（OSA）是一种常见的睡眠障碍，可发生于所有年龄组和性别，且具有多因素性。睡眠期间气流的间歇性减少会随着时间的推移导致缺氧和高碳酸血症，进而引发晨起头痛、系统性和肺动脉高压以及红细胞增多症。夜间睡眠碎片化会导致白天嗜睡、疲劳、记忆问题以及抑郁和焦虑等情绪症状。这些继发性情绪症状很容易被医疗保健提供者忽视，因为他们将其视为原发性疾病，从而导致不必要的抗抑郁药处方。本研究调查持续气道正压通气（CPAP）对阻塞性睡眠呼吸暂停患者抑郁症状的影响。我们使用PubMed、PubMed Central（PMC）和MEDLINE进行数据收集。我们将阻塞性睡眠呼吸暂停、抑郁、焦虑、情绪症状、心理症状和持续气道正压通气作为关键词，单独使用或组合使用。检索于2020年11月5日结束，检索范围限于2010年至检索当天。然而，为了更好地洞察该主题的某些方面，也纳入了一些2010年之前发表的论文。我们纳入了使用任何一种经过验证的量表（如贝克抑郁量表（BDI）、状态-特质焦虑量表（STAI）、医院焦虑抑郁量表（HADS）或汉密尔顿抑郁量表（HAM-D））来测量持续气道正压通气对情绪症状影响的文章。我们最初的检索产生了131篇文章。其中21篇符合综述标准。21项研究中有4项显示持续气道正压通气治疗对阻塞性睡眠呼吸暂停相关情绪症状没有改善，而其他研究报告了对情绪、白天嗜睡、认知和患者生活质量的有益影响。
