抑郁症状与阻塞性睡眠呼吸暂停发病风险的关联性研究

Association between Depressive Symptoms and the Risk of Developing Obstructive Sleep Apnea

摘要: 目的：探讨抑郁症状和阻塞性睡眠呼吸暂停(OSA)发病风险之间的关联。方法：我们使用了美国国家健康与营养调查(NHANES) 2005~2008年间的数据。共纳入8488名受试者。使用病人健康问卷量表(PHQ-9)评估受试者的抑郁程度，根据PHQ-9问卷得分将受试者分为无抑郁、轻度抑郁和中重度抑郁；使用睡眠问卷及血压问卷相结合评估受试者的OSA患病风险，将受试者分为OSA低危组和高危组。采用二元logistic回归模型和限制性立方样条模型分析抑郁症状和OSA患病风险之间的相关性。结果：二元logistic回归模型结果显示，以无抑郁组为参照，在控制了潜在混杂因素后，轻度抑郁和中重度抑郁组OSA患病风险均增高。限制性立方样条回归模型结果显示抑郁程度和OSA患病风险之间呈现斜率逐渐降低的递增型非线性关系，且随着抑郁程度加重，女性OSA患病风险较男性增高。结论：抑郁症严重程度和OSA患病风险之间呈现正相关，且两者之间的相关性存在性别差异，女性中重度抑郁症患者OSA患病风险较男性增高。

Abstract: Objective: To explore the association between depressive symptoms and the risk of developing ob-structive sleep apnea (OSA). Methods: We used data from the National Health and Nutrition Exami-nation Survey (NHANES) between 2005 and 2008. A total of 8488 subjects were included. The de-gree of depression was assessed using the Patient Health Questionnaire (PHQ-9), and people were classified into no depression, mild depression, and moderate to severe depression based on PHQ-9 questionnaire scores; the risk of OSA was assessed using a combination of the Sleep Questionnaire and the Blood Pressure Questionnaire, and people were classified into low-risk and high-risk groups of OSA. Binary logistic regression models and restricted cubic spline models were used to analyze the correlation between depressive symptoms and the risk of OSA prevalence. Results: As com-pared with population in the no-depression group, the results of the binary logistic regression mod-el showed that the risk of OSA was increased in both the mildly depressed and moderately severely depressed groups after controlling for potential confounders. The results of the restricted cubic spline regression model showed an increasing nonlinear relationship with decreasing slope be-tween the degree of depression and the risk of OSA, and the risk of OSA increased in women com-pared with men as the degree of depression increased. Conclusion: A positive correlation was found between the severity of depression and the risk of OSA, and the correlation was gender-specific, with women having a higher risk of developing OSA than men in patients with moderate to severe depression.