阻塞性睡眠呼吸暂停共病抑郁障碍的研究现状及进展

李桃美; 谭璐; 唐向东

doi:10.12182/20230360505

阻塞性睡眠呼吸暂停共病抑郁障碍的研究现状及进展

doi: 10.12182/20230360505

四川大学华西医院睡眠医学中心（成都 610041）

基金项目: 国家自然科学基金项目（No. 82100108）资助

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E-mail：2372564613@qq.com

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出版历程
- 收稿日期: 2022-12-16
- 修回日期: 2023-02-17
- 网络出版日期: 2023-03-22
- 刊出日期: 2023-03-20

Current Status of and Progress in Research on Obstructive Sleep Apnea and Comorbid Depressive Disorders

Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China

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Corresponding author: E-mail: 2372564613@qq.com

摘要

摘要: 阻塞性睡眠呼吸暂停（obstructive sleep apnea, OSA）和抑郁障碍均为常见的疾病，二者存在很多相似的临床症状，如睡眠紊乱、疲乏、注意力不集中和认知功能损害。两者常同时存在，这可能跟两者存在共同的病理生理学改变有关，包括下丘脑-垂体-肾上腺（hypothalamic-pituitary-adrenal, HPA）轴激活、慢性低度炎症、氧化应激、肠道微生物改变和神经递质改变等。OSA与抑郁障碍共病后，相互影响、相互恶化，加重疾病的严重程度，增加心血管代谢性疾病的发生风险，同时还会增加治疗难度。本文从OSA共病抑郁障碍的流行病学、可能机制、危害和治疗四个方面进行综述。本综述将有助于提高临床医生对二者共病的认识，以期能够早期筛查、及时诊疗和改善预后。未来需要更多的研究探索两者共病及干预对心血管代谢的影响。
- 阻塞性睡眠呼吸暂停 /
- 抑郁障碍 /
- 共病 /
- 机制 /
- 持续气道正压通气
Abstract: Obstructive sleep apnea (OSA) and depressive disorders are common diseases in adults and they share in common many clinical symptoms, including sleep disturbance, fatigue, lack of concentration and cognitive function impairment. OSA and depressive disorders also share some common pathophysiological changes, including increased activity of the hypothalamic-pituitary-adrenal (HPA) axis, chronic low-grade inflammation, oxidative stress, and changes in gut microbiota and neurotransmitters, which may contribute to the comorbidity of OSA and depressive disorders. In the case of comorbid OSA and depressive disorders, OSA and depressive disorders may affect and exacerbate each other, thereby increasing the severity of diseases, entailing greater risk of cardiovascular and metabolic diseases, and causing greater difficulty in treatment. Herein, we summarized the latest research findings on the epidemiology, possible mechanisms, harms, and treatment of comorbid OSA and depressive disorders. This review may help improve clinicians' understanding of the comorbidity of OSA and depression disorders, thereby promoting early screening, prompt diagnosis and treatment, and improved prognosis. Further studies are needed for better understanding of the effect of the comorbidity of OSA and depressive disorders and treatment on cardiometabolic diseases.
- Obstructive sleep apnea /
- Depressive disorder /
- Comorbidity /
- Mechanism /
- Continuous positive airway pressure

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