TY - JOUR
T1 - Depressive symptoms in patients with obstructive sleep apnea
T2 - biological mechanistic pathways
AU - Chirinos Medina, Diana Andrea
AU - Gurubhagavatula, Indira
AU - Broderick, Preston
AU - Chirinos, Julio A.
AU - Teff, Karen
AU - Wadden, Thomas
AU - Maislin, Greg
AU - Saif, Hassam
AU - Chittams, Jesse
AU - Cassidy, Caitlin
AU - Hanlon, Alexandra L.
AU - Pack, Allan I.
N1 - Funding Information:
The project described was supported by Award Number R01HL080076 from the National Heart, Lung, And Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, And Blood Institute or the National Institutes of Health. Julio A. Chirinos has received consulting fees from Bristol-Myers Squibb, OPKO Healthcare, Fukuda Denshi, Microsoft Research, Merck, and Vital Labs. Julio A. Chirinos received research grants from National Institutes of Health, American College of Radiology Network, Fukuda Denshi, Bristol-Myers Squibb, Microsoft Research and CVRx Inc, and device loans from Atcor Medical. He is named as inventor in a University of Pennsylvania patent application for the use of inorganic nitrates/nitrites for the treatment of Heart Failure and Preserved Ejection Fraction. Diana A. Chirinos, Indira Gurubhagavatula, Preston Broderick, Karen Teff, Thomas Wadden, Greg Maislin, Hassam Saif, Jesse Chittams, Caitlin Cassidy, Alexandra L. Hanlon, Allan I. Pack have no conflict of interest to disclose.
Funding Information:
Conflict of interest Julio A. Chirinos has received consulting fees from Bristol-Myers Squibb, OPKO Healthcare, Fukuda Denshi, Microsoft Research, Merck, and Vital Labs. Julio A. Chirinos received research grants from National Institutes of Health, American College of Radiology Network, Fukuda Denshi, Bristol-Myers Squibb, Microsoft Research and CVRx Inc, and device loans from Atcor Medical. He is named as inventor in a University of Pennsylvania patent application for the use of inorganic nitrates/nitrites for the treatment of Heart Failure and Preserved Ejection Fraction. Diana A. Chirinos, Indira Gurubhagavatula, Preston Broderick, Karen Teff, Thomas Wadden, Greg Maislin, Hassam Saif, Jesse Chittams, Caitlin Cassidy, Alexandra L. Hanlon, Allan I. Pack have no conflict of interest to disclose.
Funding Information:
Acknowledgements The project described was supported by Award Number R01HL080076 from the National Heart, Lung, And Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, And Blood Institute or the National Institutes of Health.
Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - 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 (βBDI Total = −0.230, P = 0.003; βcognitive = −0.173, P = 0.030 (βsomatic = -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.
AB - 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 (βBDI Total = −0.230, P = 0.003; βcognitive = −0.173, P = 0.030 (βsomatic = -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.
KW - C-reactive protein
KW - Depression
KW - Inflammation
KW - Insomnia
KW - Leptin
KW - Obstructive sleep apnea
UR - http://www.scopus.com/inward/record.url?scp=85021080785&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85021080785&partnerID=8YFLogxK
U2 - 10.1007/s10865-017-9869-4
DO - 10.1007/s10865-017-9869-4
M3 - Article
C2 - 28639107
AN - SCOPUS:85021080785
SN - 0160-7715
VL - 40
SP - 955
EP - 963
JO - Journal of Behavioral Medicine
JF - Journal of Behavioral Medicine
IS - 6
ER -
