Ditmer Marta, Gabryelska Agata, Turkiewicz Szymon, Gajewski Adrian, Białasiewicz Piotr, Chałubiński Maciej, Strzelecki Dominik, Witkowska Alicja, Sochal Marcin
Department of Sleep Medicine and Metabolic Disorder, Medical University of Lodz, 6/8 Mazowiecka, 92-215 Lodz, Poland.
Department of Immunology and Allergy, Medical University of Lodz, 251 Pomorska, 92-213 Lodz, Poland.
J Clin Med. 2025 Jan 12;14(2):445. doi: 10.3390/jcm14020445.
: Serotonin and the serotonin transporter (SERT) may have a multifaceted, but not fully understood, role in obstructive sleep apnea (OSA) and its impact on mental health in this group of patients. This study aimed to investigate changes in serotonin and the serotonin transporter (SERT) and their association with depressive and insomnia symptoms. : This study included 76 participants (OSA group: = 36, control group (CG): = 40) who underwent polysomnography, while venous blood samples (evening and morning) were analyzed for serotonin and the SERT using ELISA. SERT mRNA expression in peripheral leukocytes was measured via quantitative reverse-transcription polymerase chain reaction (qRT-PCR). Participants were evaluated for depression, insomnia, and quality of life (QoL). : This study found no significant differences in SERT mRNA or serotonin between the OSA group and CG. In the CG, individuals without mood disorders had higher baseline SERT levels and evening/morning SERT ratios than those with depression. Among the OSA participants, those with good QoL had elevated serotonin levels in the evening ( = 0.028) and morning ( = 0.043) compared to those with poor QoL. Baseline SERT protein levels were higher in the CG than in the OSA group for insomnia, while SERT mRNA expression was higher in the OSA group. Linear regression models showed 13.3% and 13.1% for non-rapid eye movement sleep (NREM) apnea/hypopnea index (AHI) and AHI variability, respectively, which was accounted for by the morning SERT level, while 30.8% of the arousal index variability was explained by the morning serotonin level. : Serotonergic signaling may influence quality of life, depression, and insomnia in OSA, as well as the severity of the disease itself. Stratifying patients by clinical and laboratory phenotypes could enable more personalized treatment.
血清素和血清素转运体（SERT）可能在阻塞性睡眠呼吸暂停（OSA）及其对该组患者心理健康的影响中具有多方面作用，但尚未完全明确。本研究旨在调查血清素和血清素转运体（SERT）的变化及其与抑郁和失眠症状的关联。：本研究纳入了76名参与者（OSA组：n = 36，对照组（CG）：n = 40），这些参与者接受了多导睡眠图检查，同时使用酶联免疫吸附测定法（ELISA）分析了静脉血样本（晚上和早晨）中的血清素和SERT。通过定量逆转录聚合酶链反应（qRT-PCR）测量外周白细胞中SERT mRNA的表达。对参与者进行抑郁、失眠和生活质量（QoL）评估。：本研究发现OSA组和CG之间的SERT mRNA或血清素无显著差异。在CG中，没有情绪障碍的个体比有抑郁症的个体具有更高的基线SERT水平和晚上/早晨SERT比率。在OSA参与者中，生活质量良好的个体与生活质量差的个体相比，晚上（P = 0.028）和早晨（P = 0.043）的血清素水平升高。对于失眠，CG中的基线SERT蛋白水平高于OSA组，而OSA组中的SERT mRNA表达更高。线性回归模型显示，非快速眼动睡眠（NREM）呼吸暂停低通气指数（AHI）和AHI变异性分别有13.3%和13.1%可由早晨SERT水平解释，而觉醒指数变异性的30.8%可由早晨血清素水平解释。：血清素能信号传导可能会影响OSA患者的生活质量、抑郁和失眠，以及疾病本身的严重程度。根据临床和实验室表型对患者进行分层可以实现更个性化的治疗。
