Department of Sleep Medicine and Metabolic Disorder, Medical University of Lodz, Lodz, Poland.
Department of Immunology and Allergy, Medical University of Lodz, Lodz, Poland.
Transl Psychiatry. 2024 Oct 7;14(1):423. doi: 10.1038/s41398-024-03134-0.
Obstructive sleep apnea (OSA) is characterized by co-occurrence with affective disorders. Our study aims to investigate the association of circadian clock gene expressions, and the presence and severity of depressive symptoms in OSA patients. The study included 184 individuals, who underwent polysomnography (PSG) and had their peripheral blood collected in the evening before and the morning after the PSG. Patients were divided into two groups: the OSA (apnea-hypopnea index (AHI) > 5) and the control group (AHI < 5). RNA was extracted from peripheral blood leukocytes. Expression levels of the selected genes (BMAL1, CLOCK, PER1, CRY1, NPAS2, and NR1D1) were assessed by qRT-PCR. Questionnaire data was collected in the morning (including the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Chronotype Questionnaire (CQ), and Montgomery-Åsberg Depression Rating Scale (MADRS)). The expression of all examined circadian clock genes in OSA patients was upregulated in the morning compared to the evening (except NPAS2). No differences were observed between OSA and control groups at either time point. Additionally, there was a positive correlation between the severity of depressive symptoms (assessed with MADRS) and morning expression of circadian genes in the group of OSA patients. Finally, in multivariable linear regression, ISI score (B = 0.750, p < 0.001), AM score of CQ (B = 0.416, p = 0.007), and morning PER1 gene expression (B = 4.310, p = 0.042) were found to be predictive factors for greater severity of depression symptoms in OSA patients. Dysregulated circadian clock gene expression in OSA patients is linked to depressive symptom severity, suggesting circadian disruption may underlie affective symptoms in OSA.
阻塞性睡眠呼吸暂停（OSA）的特征是与情感障碍同时发生。我们的研究旨在探讨时钟基因表达与 OSA 患者抑郁症状的存在和严重程度之间的关系。该研究纳入了 184 名个体，他们接受了多导睡眠图（PSG）检查，并在 PSG 前一天晚上和 PSG 后第二天早上采集了外周血。患者被分为两组：OSA 组（呼吸暂停低通气指数（AHI）>5）和对照组（AHI<5）。从外周血白细胞中提取 RNA。通过 qRT-PCR 评估选定基因（BMAL1、CLOCK、PER1、CRY1、NPAS2 和 NR1D1）的表达水平。早上收集问卷数据（包括失眠严重程度指数（ISI）、Epworth 嗜睡量表（ESS）、生物钟问卷（CQ）和蒙哥马利-Åsberg 抑郁评定量表（MADRS））。与晚上相比，OSA 患者的所有检测到的生物钟基因在早上的表达均上调（除 NPAS2 外）。在两个时间点，OSA 组和对照组之间均未观察到差异。此外，在 OSA 患者组中，抑郁症状的严重程度（用 MADRS 评估）与生物钟基因的早晨表达呈正相关。最后，在多元线性回归中，ISI 评分（B=0.750，p<0.001）、CQ 的 AM 评分（B=0.416，p=0.007）和早晨 PER1 基因表达（B=4.310，p=0.042）被发现是预测 OSA 患者抑郁症状严重程度的因素。OSA 患者中生物钟基因表达的失调与抑郁症状的严重程度相关，表明昼夜节律紊乱可能是 OSA 患者情感症状的基础。
