Depressive symptoms in patients with obstructive sleep apnea: biological mechanistic pathways.

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Bibliographic Details
Title:	Depressive symptoms in patients with obstructive sleep apnea: biological mechanistic pathways.
Authors:	Chirinos, Diana, Gurubhagavatula, Indira, Broderick, Preston, Chirinos, Julio, Teff, Karen, Wadden, Thomas, Maislin, Greg, Saif, Hassam, Chittams, Jesse, Cassidy, Caitlin, Hanlon, Alexandra, Pack, Allan
Source:	Journal of Behavioral Medicine. Dec2017, Vol. 40 Issue 6, p955-963. 9p. 3 Charts.
Subjects:	C-reactive protein, Mental depression, Inflammation, Insomnia, Psychological tests, Sleep apnea syndromes, Comorbidity, Leptin, Confounding variables
Abstract:	This study examined the association between depressive symptoms, as well as depressive symptom dimensions, and three candidate biological pathways linking them to Obstructive sleep apnea (OSA): (1) inflammation; (2) circulating leptin; and (3) intermittent hypoxemia. Participants included 181 obese adults with moderate-to-severe OSA enrolled in the Cardiovascular Consequences of Sleep Apnea (COSA) trial. Depressive symptoms were measured using the Beck Depression Inventory-II (BDI-II). We assessed inflammation using C-reactive protein levels (CRP), circulating leptin by radioimmunoassay using a double antibody/PEG assay, and intermittent hypoxemia by the percentage of sleep time each patient had below 90% oxyhemoglobin saturation. We found no significant associations between BDI-II total or cognitive scores and CRP, leptin, or percentage of sleep time below 90% oxyhemoglobin saturation after controlling for relevant confounding factors. Somatic symptoms, however, were positively associated with percentage of sleep time below 90% saturation (β = 0.202, P = 0.032), but not with CRP or circulating leptin in adjusted models. Another significant predictor of depressive symptoms included sleep efficiency (β = −0.230, P = 0.003; β = −0.173, P = 0.030 (β = -0.255, P = 0.001). In patients with moderate-to-severe OSA, intermittent hypoxia may play a role in somatic rather than cognitive or total depressive symptoms. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	This study examined the association between depressive symptoms, as well as depressive symptom dimensions, and three candidate biological pathways linking them to Obstructive sleep apnea (OSA): (1) inflammation; (2) circulating leptin; and (3) intermittent hypoxemia. Participants included 181 obese adults with moderate-to-severe OSA enrolled in the Cardiovascular Consequences of Sleep Apnea (COSA) trial. Depressive symptoms were measured using the Beck Depression Inventory-II (BDI-II). We assessed inflammation using C-reactive protein levels (CRP), circulating leptin by radioimmunoassay using a double antibody/PEG assay, and intermittent hypoxemia by the percentage of sleep time each patient had below 90% oxyhemoglobin saturation. We found no significant associations between BDI-II total or cognitive scores and CRP, leptin, or percentage of sleep time below 90% oxyhemoglobin saturation after controlling for relevant confounding factors. Somatic symptoms, however, were positively associated with percentage of sleep time below 90% saturation (β = 0.202, P = 0.032), but not with CRP or circulating leptin in adjusted models. Another significant predictor of depressive symptoms included sleep efficiency (β = −0.230, P = 0.003; β = −0.173, P = 0.030 (β = -0.255, P = 0.001). In patients with moderate-to-severe OSA, intermittent hypoxia may play a role in somatic rather than cognitive or total depressive symptoms. [ABSTRACT FROM AUTHOR]
ISSN:	01607715
DOI:	10.1007/s10865-017-9869-4