The effect of continuous positive air pressure therapy on depressive disorders and quality of life in patients with obstructive sleep apnea

[R. P. Suša]

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Uvod: Opstruktivna sleep apnea (OSA) je stanje prouzrokovano ponavljanim epizodama kolapsa gornjih disajnih puteva i opstrukcijom praćenom hrkanjem sa ili bez desaturacije kiseonika, hiperkapnijom i fragmentacijom sna. Do danas su ispitani somatski komorbiditeti OSA, dok se na psihijatrijske poremećaje u ovoj grupaciji pacijenata manje obraćala pažnja. Cilj ovoga istraživanja bio je da se utvrdi prevalenca anksioznih i depresivnih poremećaja kod pacijenata sa OSA u našoj populaciji, kao i efekat primene aparata sa kontinuiranim pozitivnim pritiskom vazduha (CPAP) na simptome depresije i anksioznosti i kvalitet života kod pacijenata koji imaju dijagnostikovanu OSA. Materijal i metode: Istraživanje je dizajnirano kao opservaciona prospektivna studija, po tipu studija slučaj-kontrola i obuhvatilo je 104 pacijenta. U studiju su uključeni pacijenti sa srednje-teškim i teškim oblikom OSA (ANI≥15). Istraživanu populaciju činile su dve grupe pacijenata: terapijska (CPAP) i kontrolna. Dužina praćenja pacijenata bila je godinu dana. Rezultati: U ukupnom uzorku ispitivanih pacijenata prosečna vrednost AHI veća je kod muškaraca, pušača i gojaznih. Prema skali BDI svaki treći pacijent imao je blagi poremećaj raspoloženja. Prema HADSD depresivni poremećaj imalo je 16,3% pacijenata, a 12,5% anksiozni poremećaj (HADSA). Dobra komplijansa u korišćenju CPAP aparata (nađena kod 2/3 pacijenata) dovodi do značajno većeg pada prosečnih vrednosti AHI, kao i skorova koji su korišđeni za procenu anksiozno-depresivnih poremećaja i kvaliteta života (BDI, VAS, HADSD i HADSA). Zaključak: Primena CPAP-a, posebno u grupi komplijantnih pacijenata (sa OSA), dovodi do značajnog smanjenja simptoma depresivnih i anksioznih poremećaja i poboljšanja kvaliteta života kod pacijenata sa srednje teškom i teškom OSA.

Introduction: Obstructive sleep apnea (OSA) is a condition caused by repeated episodes of upper airway collapse and obstruction accompanied by snoring with or without oxygen desaturation, hypercapnia, and sleep fragmentation. To date, somatic comorbidities of OSA have been examined, while less attention has been paid to psychiatric disorders in this group of patients. The aim of this study was to determine the prevalence of anxiety and depressive disorders in patients with OSA in our population, as well as the effect of continuous positive airway pressure (CPAP) on symptoms of depression and anxiety and quality of life in patients diagnosed with OSA. Material and methods: The research was designed as an observational, prospective, casecontrol study and included 104 patients. Patients with moderate and severe OSA (AHI≥15) were included in the study. The studied population consisted of two groups of patients: therapeutic (CPAP) and control. The length of patient follow-up was one year. Results: In the total sample of examined patients, the average value of AHI was higher in men, smokers and obese people. According to the BDI scale, every third patient had a mild mood disorder. According to HADSD, 16.3% of patients had a depressive disorder, and 12.5% had an anxiety disorder (HADSA). Good compliance in the use of the CPAP device (found in 2/3 of patients) leads to a significantly greater decrease in average AHI values, as well as scores used to assess anxiety-depressive disorders and quality of life (BDI, VAS, HADSD and HADSA). Conclusion: The use of CPAP, especially in the group of compliant patients (with OSA), leads to a significant reduction in the symptoms of depressive and anxiety disorders and an improvement in the quality of life in patients with moderate and severe OSA.

opstruktivna sleep apnea, depresivni poremećaji, anksioznost, kvalitet života, kontinuirani pozitivni pritisak u disajnim putevima

obstructive sleep apnea, depressive disorders, anxiety, quality of life, continuous positive airway pressure

616.24-008.4-08(043.3)

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