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在阻塞性睡眠呼吸暂停患者短期和长期使用持续气道正压通气(CPAP)治疗后,抑郁症状、情绪调节和反应性得到改善。

Improved depressive symptoms, and emotional regulation and reactivity, in individuals with obstructive sleep apnea after short- and long-term CPAP therapy use.

作者信息

Pattison Emily, Tolson Julie, Barnes Maree, Saunders William J, Bartlett Delwyn, Downey Luke A, Jackson Melinda L

机构信息

Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Australia; RMIT University, School of Health and Biomedical Science, Melbourne, Australia.

Institute for Breathing and Sleep, Austin Health, Heidelberg, Melbourne, Australia.

出版信息

Sleep Med. 2023 Nov;111:13-20. doi: 10.1016/j.sleep.2023.08.024. Epub 2023 Sep 1.

DOI:10.1016/j.sleep.2023.08.024
PMID:37714031
Abstract

Obstructive Sleep Apnoea (OSA) is associated with high rates of depression; however, if and how treatment of OSA improves depressive symptoms is unclear. To further understand this link we considered the role of emotional regulation - the ability to control and express our emotional responses - thought to be a central component of depression. This study aimed to assess changes in depressive symptoms and emotional responses in individuals with OSA after 4- and 12-months of continuous positive airway pressure (CPAP) treatment. One-hundred and twenty-one OSA participants (50 female, M = 51.93; mean AHI = 36.27) were recruited from a tertiary clinical sleep service prior to CPAP initiation, and randomised to either a CPAP group or a 4 month wait-list group. Participants completed the Center for Epidemiological Studies Depression Scale, the Emotional Reactivity Scale and the Difficulties in Emotion Regulation Scale at baseline, and 1-, 2-, and 4-months follow-up. The CPAP group also completed the questionnaires 12-months after CPAP initiation. CPAP use at 1 month and 12 months was 5.1h/night and 4.9h/night, respectively. Significant improvements in depressive symptoms, emotional regulation and reactivity, and subjective sleepiness were observed after 4 months in both groups, however, the within group changes were only significant for those using CPAP. After 12-months of CPAP treatment, these improvements were maintained. There was no association between CPAP treatment adherence and improvements in any outcome. CPAP treatment for 12 months may reduce symptoms of depression and improve emotional regulation in individuals with OSA.

摘要

阻塞性睡眠呼吸暂停(OSA)与高抑郁症发病率相关;然而,OSA治疗是否以及如何改善抑郁症状尚不清楚。为了进一步理解这种联系,我们考虑了情绪调节的作用——控制和表达情绪反应的能力——被认为是抑郁症的核心组成部分。本研究旨在评估持续气道正压通气(CPAP)治疗4个月和12个月后,OSA患者抑郁症状和情绪反应的变化。121名OSA参与者(50名女性,平均年龄51.93岁;平均呼吸暂停低通气指数=36.27)在开始CPAP治疗前从三级临床睡眠服务机构招募,并随机分为CPAP组或4个月等待名单组。参与者在基线时以及随访1个月、2个月和4个月时完成了流行病学研究中心抑郁量表、情绪反应量表和情绪调节困难量表。CPAP组在开始CPAP治疗12个月后也完成了问卷。1个月和12个月时CPAP的使用时间分别为每晚5.1小时和4.9小时。两组在4个月后抑郁症状、情绪调节和反应性以及主观嗜睡方面均有显著改善,然而,组内变化仅在使用CPAP的人群中显著。CPAP治疗12个月后,这些改善得以维持。CPAP治疗依从性与任何结果的改善之间均无关联。CPAP治疗12个月可能会减轻OSA患者的抑郁症状并改善情绪调节。

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