Obstructive sleep apnea (OSA) is a common sleep disorder characterized by narrow upper airway muscles causing partial reduction or complete absence of respiration during sleep. OSA leads to a variety of health complications and is commonly associated with major depressive disorder (MDD). The bidirectionality of these disorders is not well understood despite having common disruptions in sleep architecture and ANS dysfunction. In this study, we evaluated the difference in sleep microstructure in OSA and OSA/MDD patients and assessed heart rate parameters during CAP and non-CAP phases of both study groups. We identified several demographic associations with sleep microstructure along with cardiovascular and ANS measures. Lastly, we employed stepwise regression to predict the most important features in distinguishing MDD in OSA patients. Significant differences were found in weight (kg), height (cm), and gender distribution (M/F). These include lower average weight (kg) and height (cm) in OSAD+ subjects, and lower OSA prevalence in male subjects. Additionally, OSAD+ patients had an increased N2 and movement arousal index, while having reduced N3. Major associations were found in age, weight (kg), BMI (kg/m2), and height (cm). In particular, N2, N3, no. of REM cycles, AHI, O2 saturation and desaturation, sleep efficiency, snoring time, mean/max pulse, LF, vLF, LF/HF ratio, and SampEn showed various positive and negative correlations with demographics. Predictive models for depression identified β power, vLF, and SampEn as significant discriminators of depression during CAP, while total power, vLF, and SampEn were found in non-CAP. These findings suggest an important role of demographic factors, sleep microstructure, and frequency and non-linear components of heart rate variability in understanding the effect of depression in sleep disordered breathing.
Investigating the Role of Sleep Disordered Breathing on Major Depressive Disorder in the UAE
Shukir, S. (Author). 22 May 2024
Student thesis: Master's Thesis