Depressive Symptoms in Comorbid Obstructive Sleep Apnea and Insomnia: An Integrative Review

2021 ◽  
pp. 019394592198965
Author(s):  
Bomin Jeon ◽  
Faith S. Luyster ◽  
Judith A. Callan ◽  
Eileen R. Chasens
Keyword(s):  
Obstructive Sleep Apnea ◽  
Depressive Symptoms ◽  
Sleep Apnea ◽  
Control Design ◽  
Case Control ◽  
Integrative Review ◽  
Study Quality ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
The Relationship

The purpose of this integrative review was to synthesize evidence concerning the relationship between comorbid obstructive sleep apnea and insomnia (OSA+I), and depressive symptoms. OSA and insomnia are common sleep disorders, recently comorbid OSA+I has been recognized as prevalent in adults. Although each sleep disorder increases the risk and severity of depressive symptoms, the effect of comorbid OSA+I on depressive symptoms remains unclear. A systematic search of PubMed, CINAHL, and PsycINFO identified 15 data-based studies. All the studies were observational with either a cross-sectional (n = 14) or a case-control design (n = 1). Study quality was assessed. Most of the studies (n = 14) indicated that comorbid OSA+I had an additive role on depressive symptoms. Insomnia appeared to have a more important role than OSA in increasing the severity of depressive symptoms in persons with comorbid OSA+I.

scholarly journals Stress in obstructive sleep apnea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jasmine L. Wong ◽  
Fernando Martinez ◽  
Andrea P. Aguila ◽  
Amrita Pal ◽  
Ravi S. Aysola ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Depressive Symptoms ◽  
Sleep Apnea ◽  
Perceived Stress ◽  
Stress Reduction ◽  
Psychological Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
General Anxiety Disorder ◽  
Obstructive Sleep

AbstractPeople with obstructive sleep apnea (OSA) often have psychological symptoms including depression and anxiety, which are commonly treated with anti-depression or anti-anxiety interventions. Psychological stress is a related symptom with different intervention targets that may also improve mental state, but this symptom is not well characterized in OSA. We therefore aimed to describe stress in relation to other psychological symptoms. We performed a prospective cross-sectional study of 103 people, 44 untreated OSA (mean ± s.d. age: 51.2 ± 13.9 years, female/male 13/31) and 57 healthy control participants (age: 46.3 ± 13.8 years, female/male 34/23). We measured stress (Perceived Stress Scale; PSS), excessive daytime sleepiness (Epworth Sleepiness Scale; ESS), depressive symptoms (Patient Health Questionnaire; PHQ-9), and anxiety symptoms (General Anxiety Disorder; GAD-7). We compared group means with independent samples t-tests and calculated correlations between variables. Mean symptom levels were higher in OSA than control, including PSS (mean ± s.d.: OSA = 15.3 ± 6.9, control = 11.4 ± 5.5; P = 0.002), GAD-7 (OSA = 4.8 ± 5.0, control = 2.1 ± 3.9; P = 0.02), PHQ-9 (OSA = 6.9 ± 6.1, control = 2.6 ± 3.8; P = 0.003) and ESS (OSA = 8.1 ± 5.3, control = 5.0 ± 3.3; P = 0.03). Similar OSA-vs-control differences appeared in males, but females only showed significant differences in PHQ-9 and ESS, not PSS or GAD-7. PSS correlated strongly with GAD-7 and PHQ-9 across groups (R = 0.62–0.89), and moderately with ESS. Perceived stress is high in OSA, and closely related to anxiety and depressive symptoms. The findings support testing stress reduction in OSA.

scholarly journals The Relationship between Obstructive Sleep Apnea (OSA) and Adherence of Antihypertensive Consumption in Regular Hemodialysis Patient

2019 ◽  
Vol 2 (2) ◽  
pp. 96-103
Author(s):  
Afrilia Rosada Lubis ◽  
Riri Andri Muzasti
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Antihypertensive Drugs ◽  
Cross Sectional Study ◽  
Secondary Hypertension ◽  
Drug Consumption ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
The Relationship

Background. Based on the Indonesian Renal Registry (IRR) data in 2015, the highest incidence of comorbidities in hemodialysis patients in Indonesia was hypertension (50%). Obstructive Sleep Apnea (OSA) is one of the causes of secondary hypertension, the characteristics of hypertension in OSA are more resistant to treatment. One of the causes of resistant hypertension is patient non-compliance with the consumption of antihypertensive drugs. Aim. To determine the relationship of adherence of consumption of antihypertensive drugs with obstructive sleep apnea in regular HD patients. Method. This cross-sectional study involved 89 outpatients in HD units at the Rasyida Kidney Hospital in 2018. Data was obtained through interview using the STOP-BANG questionnaire to assess the of risk of OSA and using Morisky Medication Adherence Scale (MMAS) questionnaire to measure the compliance of  drug consumption. Results.The prevalence of OSA  in HD patients was (39.3%). There was no significant relationship between adherence with drug consumption and OSA risk, but in bivariate analysis, age (p = 0.0001), body mass index (BMI) (p = 0.001), and gender (p = 0.03) were significantly related to OSA. In multivariate, age and BMI were significantly associated with OSA (OR: 6.449, 95% CI 2.246 ± 18.520, p = 0.001; OR: 6.130, 95% CI 2.105 ± 17.849, p = 0.001). Conclusion. OSA was not statistically related to adherence to antihypertensive drug consumption in HD patients but was significantly associated with age and BMI.     Keyword. Adherence to antihypertensive consumption, hemodialysis, obstructive sleep apnea.

Interaction of cross-sectional area, driving pressure, and airflow of passive velopharynx

1997 ◽  
Vol 83 (3) ◽  
pp. 851-859 ◽  
Author(s):  
Shiroh Isono ◽  
Thom R. Feroah ◽  
Eric A. Hajduk ◽  
Rollin Brant ◽  
William A. Whitelaw ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Airway Pressure ◽  
Cross Sectional Area ◽  
Driving Pressure ◽  
Sectional Area ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Pharyngeal Muscles ◽  
The Relationship

Isono, Shiroh, Thom R. Feroah, Eric A. Hajduk, Rollin Brant, William A. Whitelaw, and John E. Remmers. Interaction of cross-sectional area, driving pressure, and airflow of passive velopharynx. J. Appl. Physiol. 83(3): 851–859, 1997.—Previous studies have shown that, when the pharyngeal muscles are relaxed, the velopharynx is a highly compliant segment of the pharynx. Thus, under these circumstances, cross-sectional area of the velopharynx ( A VP), driving pressure across the velopharynx (ΔP), and inspiratory airflow (V˙i) will be mutually interdependent variables. The purpose of the present investigation was to describe the interrelation among these three variables during inspiration. We studied 15 sleeping patients with obstructive sleep apnea/hypopnea when the pharyngeal muscles were rendered hypotonic by applying continuous positive airway pressure to the nasal airway. A VP, determined by endoscopic imaging, was significantly greater at onset ofV˙i limitation than at minimum oropharyngeal pressure ( P < 0.01). Snoring was never observed duringV˙ilimitation. In a subgroup of six patients, values for ΔP,V˙i, and A VP were obtained at 0.1-s intervals at various levels of mask pressure. For these six patients, the mathematical expressionV˙i = 0.657( A VP/ A max) ⋅ ΔP0.332, where A max is maximal A VP, described the relationship among the three variables ( R 2 = 0.962) for flow-limited and non-flow-limited inspirations. The impedance of the passive velopharynx, defined as ΔP0.33/V˙, was inversely related to A VP and increased dramatically when A VP was <0.3 cm2. In summary, we observed a progressive decrease in A VP during flow-limited inspiration in patients with obstructive sleep apnea. This constriction of the velopharynx contributes to an increase in velopharyngeal impedance that, in turn, counterbalances the increase in ΔP during flow limitation.

scholarly journals Obstructive Sleep Apnea and Periodontal Disease: A Systematic Review

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 640
Author(s):  
Daniela Lembo ◽  
Francesco Caroccia ◽  
Chiara Lopes ◽  
Francesco Moscagiuri ◽  
Bruna Sinjari ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Periodontal Disease ◽  
Quality Assessment ◽  
Case Control ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Obstructive Sleep

Background and Objectives: The objective of this study was to evaluate the association between periodontal disease and obstructive sleep apnea syndrome (OSAS). Materials and Methods: Electronic search using PubMed, Scopus, LILACS, and Cochrane library was carried out for randomized controlled trials, cohort, case-control, longitudinal and epidemiological studies on humans published from January 2009 until September 2020. The participants had to be male and female adults who were diagnosed with OSAS either by overnight polysomnography (carried out at a sleep laboratory or at home) or by a home sleep testing monitor (Apnea Risk Evaluation System). Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale (NOS) for case-control studies while an adapted form of NOS was used for cross-sectional studies. Results: Ten studies fulfilled the inclusion criteria of our review, 5 were case-control studies, and 5 cross-sectional. Sample size ranged from 50 to 29,284 subjects, for a total of 43,122 subjects, 56% of them were male, their age ranged from 18 to 85 years old. The heterogeneity among the studies regarding the classification of periodontal disease, and the different methods for OSAS severity assessment, complicated the comparison among the studies. Conclusions: There is low evidence of a possible association between OSAS and periodontitis. The pathophysiological mechanism, cause-effect, or dose-response relationship are still unclear. Further studies are needed and should use a precise classification of OSAS subjects, while the new classification of periodontitis from the World Workshop of Chicago 2017 should be used for the periodontal assessment.

scholarly journals The relationship between obstructive sleep apnea and insomnia: a population-based cross-sectional polysomnographic study

2019 ◽  
Vol 54 ◽  
pp. 126-133 ◽  
Author(s):  
B.L. Uhlig ◽  
K. Hagen ◽  
M. Engstrøm ◽  
M. Stjern ◽  
G.B. Gravdahl ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Population Based ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
The Relationship

scholarly journals Obstructive Sleep Apnea (OSA) and depressive symptoms

2009 ◽  
Vol 67 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Michele Dominici ◽  
Marleide da Mota Gomes
Keyword(s):  
Obstructive Sleep Apnea ◽  
Depressive Symptoms ◽  
Sleep Apnea ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Apnea Hypopnea Index ◽  
Analysis Model ◽  
Cross Sectional ◽  
Obstructive Sleep

BACKGROUND: The relationship between obstructive sleep apnea (OSA) and depressive symptoms is ambiguous in the literature. PURPOSE: To investigate if there is a correlation between depressive symptoms and the severity of OSA. METHOD: A retrospective, cross-sectional study of data from 123 consecutive adults patients with neither mental illness nor psychotropic drugs intake, referred to a sleep laboratory for an evaluation of OSA. For the statistical analysis (uni- and multivariate), we used the following variables: gender and age, as well as scores based on several scales and indexes such as Beck Depressive Inventory (BDI), Epworth Sleepiness Scale (ESS), Body Mass Index (BMI) and Apnea-Hypopnea Index (AHI). RESULTS: Univariate analysis found a weak but statistically significant negative correlation between BDI and AHI. However, with the multivariate logistic regression analysis model, the inverse relation between AHI and BDI no longer has statistical significance. CONCLUSION: There is no causal relationship between OSA and depressive symptoms in the population studied.

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