ABSTRACT
Objective To explore the factors that contribute to the anxiety and depression in obstructive sleep apnea hypopnea syndrome (OSAHS) patients in terms of excessive daytime sleepiness (EDS) and sleep quality.Methods A total of 196 OSAHS patients,including 103 severe patients and 93 mild-moderate patients,were enrolled.Polysomnography was carried on at the sleep center of the First Hospital of China Medical University between May 2013 and November 2015.According to the Epworth sleepiness scale (ESS) and the subject daytime sleepiness symptom,all patients were divided into EDS group and non-EDS group.The patients' general information and subjective symptoms were recorded.Emotional states were assessed with self-rating anxiety scale (SAS) and self-rating depression scale (SDS).Sleep quality was evaluated with Pittsburgh sleep quality index (PSQI).The anxiety and depression related factors were studied by regression analysis.Results (1) In severe OSAHS group,the patients with EDS showed higher PSQI(6.22± 2.57 vs.4.05± 3.72,P<0.01) and oxygen desaturation index(ODI)[(57.70±17.53) events/h vs.(48.23 ± 22.01)events/h,P<0.05] when compared with those without EDS.(2) In both severe and mild-moderate OSAHS groups,the patients with EDS presented higher SAS scores (severe:33.86±7.60 vs.28.95 ± 4.71,mild-moderate:37.46± 10.68 vs.33.40± 11.07,P<0.05)and SDS scores(severe:32.81 ± 8.36 vs.28.90±4.53,mild-moderate:36.98± 12.77 vs.31.70±10.94,P<0.05)when compared with those without EDS.(3) The multiple regression analysis showed that the SAS scores were related to ESS,PSQI,insomnia and nasal obstruction (R2=0.356,P<0.05),and the SDS scores were related to ESS,PSQI and insomnia(R2=0.344,P<0.05).Conclusions The anxiety and depression of OSAHS patients are closely related to the severity of EDS and sleep quality.Both severe and mild-moderate OSAHS patients with EDS have worse anxiety and depression scores.
ABSTRACT
Objective To investigate the effects of chronic intermittent hypoxia on somatotropic axis hormone levels in rats.Methods Mature male Wistar rats were exposed to air or intermittent hypoxia randomly.The serum levels of growth hormone-releasing hormone (GHRH),growth hormone (GH) and somatostatin (SS) were measured before exposure,at the 4th,8th,and 12th week after exposure.Different hormone levels in two groups were compared and analyzed.Results Compared with the control group,GHRH levels in chronic intermittent hypoxic group showed a significant decline at the 4th week [(732.77± 46.99)pg/ml vs.(893.59±40.00) pg/ml,P<0.05],while SS levels at the 8th week [(30.71 ±2.27) pg/ml vs.(44.69±3.36) pg/ml,P<0.05] and GH levels at the 12th week [(1.20±0.29) ng/ml vs.(2.06±0.13) ng/ml,P<0.05]were similarly reduced.As the duration of intermittent hypoxia was prolonged,the GHRH levels did not decrease further [4th week (732.77±46.99) pg/ml vs.8th week (607.54± 131.61) pg/ml vs.12th week (730.05±40.63) pg/ml,P>0.05].However,the serum SS levels decreased further from the 8th week to the 12th week [(30.71±2.27) pg/ml vs.(24.41±4.06) pg/ml,P<0.05].Conclusion Chronic intermittent hypoxia might inhibit the function of somatotropic axis.Hypothalamic hormones are the earlyonesto be influenced,thereafter the entire axis.