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囊性纤维化和非囊性纤维化支气管扩张症患者中抑郁症与阻塞性睡眠呼吸暂停的关联

The Association of Depression with Obstructive Sleep Apnea in Patients with Cystic and Non-Cystic Fibrosis Bronchiectasis.

作者信息

Balcan Baran, Vezir Duygu, Olgun Yildizeli Sehnaz, Kocakaya Derya, Ceyhan Berrin

机构信息

Department of Pulmonary Medicine, Faculty of Medicine, Koc University, Istanbul 34460, Turkey.

Department of Pulmonary Medicine, Sureyyapasa Teaching and Researh Hospital, Istanbul 34844, Turkey.

出版信息

Life (Basel). 2024 Aug 19;14(8):1026. doi: 10.3390/life14081026.

Abstract

Obstructive sleep apnea (OSA) and cystic fibrosis (CF) are chronic conditions that profoundly impact quality of life. OSA, characterized by repeated episodes of upper airway collapse, can exacerbate CF symptoms due to nocturnal airway obstruction. Recent studies highlight the prevalence of OSA in CF patients, especially in adults, and its detrimental effects on health and quality of life. From April 2019 to December 2021, we conducted a study with 104 bronchiectasis patients at Marmara University Pendik Training and Research Hospital. After exclusions, 70 participants (35 CF and 35 non-CF) were included. Sleep parameters were assessed with polysomnography, and depressive mood was evaluated using the Zung Self-Rating Depression Scale (SDS). Daytime sleepiness was measured using the Epworth Sleepiness Scale (ESS). The statistical analyses included t-tests, chi-square tests, and logistic regression. Among the CF patients, depressive mood was significantly associated with female sex (OR: 4.28, 95% CI: 1.27-12.04) and anemia (OR: 7.87, 95% CI: 1.50-41.27). Higher ESS scores indicated greater daytime sleepiness in the depressive groups ( = 0.051). Depressive CF patients also had a significantly longer disease duration and more frequent annual exacerbations. No significant differences were found in total sleep time, sleep efficiency, or sleep stages between the depressive and non-depressive groups. A lower forced vital capacity (FVC) was observed in the depressive CF patients, although not significantly. Depression is prevalent among adult CF patients with OSA, with significant associations with female sex and anemia. These findings underscore the need for integrated care addressing both physical and mental health aspects, including interventions for respiratory symptoms, anemia management, and sleep quality enhancement to improve overall quality of life.

摘要

阻塞性睡眠呼吸暂停(OSA)和囊性纤维化(CF)是严重影响生活质量的慢性疾病。OSA以上呼吸道反复塌陷为特征,可因夜间气道阻塞而加重CF症状。最近的研究强调了CF患者中OSA的患病率,尤其是在成年人中,以及它对健康和生活质量的有害影响。2019年4月至2021年12月,我们在马尔马拉大学彭迪克培训与研究医院对104例支气管扩张患者进行了一项研究。排除后,纳入了70名参与者(35例CF患者和35例非CF患者)。使用多导睡眠图评估睡眠参数,并使用zung自评抑郁量表(SDS)评估抑郁情绪。使用爱泼华嗜睡量表(ESS)测量白天嗜睡情况。统计分析包括t检验、卡方检验和逻辑回归。在CF患者中,抑郁情绪与女性性别(OR:4.28,95%CI:1.27-12.04)和贫血(OR:7.87,95%CI:1.50-41.27)显著相关。较高的ESS评分表明抑郁组白天嗜睡程度更高(P=0.051)。抑郁的CF患者疾病持续时间也显著更长,年度加重更频繁。抑郁组和非抑郁组在总睡眠时间、睡眠效率或睡眠阶段方面未发现显著差异。抑郁的CF患者的用力肺活量(FVC)较低,尽管差异不显著。抑郁症在患有OSA的成年CF患者中很普遍,与女性性别和贫血显著相关。这些发现强调了需要综合护理,解决身心健康方面的问题,包括针对呼吸道症状的干预措施、贫血管理和改善睡眠质量,以提高整体生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bd1/11355093/5363aa9980af/life-14-01026-g001.jpg

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