Li Tao-Mei, Tan Lu, Tang Xiang-Dong
Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Mar;54(2):252-256. doi: 10.12182/20230360505.
Obstructive sleep apnea (OSA) and depressive disorders are common diseases in adults and they share in common many clinical symptoms, including sleep disturbance, fatigue, lack of concentration and cognitive function impairment. OSA and depressive disorders also share some common pathophysiological changes, including increased activity of the hypothalamic-pituitary-adrenal (HPA) axis, chronic low-grade inflammation, oxidative stress, and changes in gut microbiota and neurotransmitters, which may contribute to the comorbidity of OSA and depressive disorders. In the case of comorbid OSA and depressive disorders, OSA and depressive disorders may affect and exacerbate each other, thereby increasing the severity of diseases, entailing greater risk of cardiovascular and metabolic diseases, and causing greater difficulty in treatment. Herein, we summarized the latest research findings on the epidemiology, possible mechanisms, harms, and treatment of comorbid OSA and depressive disorders. This review may help improve clinicians' understanding of the comorbidity of OSA and depression disorders, thereby promoting early screening, prompt diagnosis and treatment, and improved prognosis. Further studies are needed for better understanding of the effect of the comorbidity of OSA and depressive disorders and treatment on cardiometabolic diseases.
阻塞性睡眠呼吸暂停(OSA)和抑郁症是成人常见疾病,它们有许多共同的临床症状,包括睡眠障碍、疲劳、注意力不集中和认知功能损害。OSA和抑郁症还存在一些共同的病理生理变化,包括下丘脑-垂体-肾上腺(HPA)轴活性增加、慢性低度炎症、氧化应激以及肠道微生物群和神经递质的变化,这些可能导致OSA和抑郁症的共病。在OSA和抑郁症共病的情况下,OSA和抑郁症可能相互影响并加重,从而增加疾病的严重程度,带来更大的心血管和代谢疾病风险,并导致治疗难度加大。在此,我们总结了OSA和抑郁症共病在流行病学、可能机制、危害及治疗方面的最新研究发现。本综述可能有助于提高临床医生对OSA和抑郁症共病的认识,从而促进早期筛查、及时诊断和治疗,并改善预后。需要进一步研究以更好地了解OSA和抑郁症共病及其治疗对心脏代谢疾病的影响。