Wonhee Lee1, Sang-Ahm Lee, Yoo-Sam Chung, Woo Sung Kim. 1. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Korea.
Abstract
PURPOSE: We determined the relationship between apnea severity and depressive symptoms in a large sample of the newly diagnosed male patients with severe obstructive sleep apnea (OSA). METHODS: Data were collected from patients who received polysomnography due to suspected OSA. The questionnaires included the Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS), and Medical Outcomes Study (MOS)-Sleep Scale, for which Sleep Problems Index-1 (SPI-1) was calculated. The apnea-hypopnea index (AHI) and respiratory distress index (RDI) were used to measure apnea severity. The mediational model, which states that OSA severity affects depression through a mediator, was tested here. RESULTS: In total, 302 male patients with severe OSA participated. The mean patient age was 48.4 years (SD = 11.3 years). The BDI was ≥ 10 in 118 patients (39%) and was significantly associated with body mass index (r = 0.114; p = 0.048), ESS (r = 0.164; p = 0.004), SPI-1 (r = 0.453; p < 0.001), and RDI (r = 0.126; p = 0.029). According to the linear regression analyses, the RDI is not independently associated with the BDI. The strongest predictor of BDI was sleep quality (SPI-1; β = 0.425; p < 0.001). The bootstrap method confirmed that the depressive effects of RDI are significantly mediated by poor sleep quality (bootstrapped 95% CI 0.0113-0.0632). CONCLUSIONS: There is evidence of a mediational role of subjective sleep quality on the relationship between apnea severity and depressive symptoms in male patients with severe OSA.
PURPOSE: We determined the relationship between apnea severity and depressive symptoms in a large sample of the newly diagnosed male patients with severe obstructive sleep apnea (OSA). METHODS: Data were collected from patients who received polysomnography due to suspected OSA. The questionnaires included the Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS), and Medical Outcomes Study (MOS)-Sleep Scale, for which Sleep Problems Index-1 (SPI-1) was calculated. The apnea-hypopnea index (AHI) and respiratory distress index (RDI) were used to measure apnea severity. The mediational model, which states that OSA severity affects depression through a mediator, was tested here. RESULTS: In total, 302 male patients with severe OSA participated. The mean patient age was 48.4 years (SD = 11.3 years). The BDI was ≥ 10 in 118 patients (39%) and was significantly associated with body mass index (r = 0.114; p = 0.048), ESS (r = 0.164; p = 0.004), SPI-1 (r = 0.453; p < 0.001), and RDI (r = 0.126; p = 0.029). According to the linear regression analyses, the RDI is not independently associated with the BDI. The strongest predictor of BDI was sleep quality (SPI-1; β = 0.425; p < 0.001). The bootstrap method confirmed that the depressive effects of RDI are significantly mediated by poor sleep quality (bootstrapped 95% CI 0.0113-0.0632). CONCLUSIONS: There is evidence of a mediational role of subjective sleep quality on the relationship between apnea severity and depressive symptoms in male patients with severe OSA.
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