Page 49 - JCBP-2-1

Journal of Clinical and
Basic Psychosomatics Depressive disorder obstructive sleep apnea hypothalamic inflammation

previous report , the prevalence of OSA in patients with differences were found in the prevalence of depressive
[27]
depressive disorder surpasses that in patients with bipolar disorders between patients with mild OSA and those
disorder or schizophrenia. In addition, it is worth noting without . However, it is worth mentioning that treatment
[36]
that the BMI serves as a predictor for OSA. with continuous positive airway pressure can improve not
Depression is among the most prevalent mood only the AHI in OSA patients but also alleviate depressive
[37]
disorders in obese patients. In this study, middle-aged symptoms . The intricate relationship between OSA and
and young obese male patients with depressive disorders depression in obese patients remains a topic that warrants
[7]
exhibited a significant increase in REI and a lesser decrease further investigation .
in the lowest oxygen saturation. Among the 110 psychiatric OSA and obesity stand out as two of the most prevalent
patients we examined, 72.48% had an AHI of ≥15, and public health problems. One important avenue of research
84.4% had an AHI of ≥5 sleep events per hour, as recorded lies in the exploration of hypothalamic inflammation,
by polysomnography (PSG) . The diagnostic criteria for which is an important area for investigation .
[28]
[38]
OSA primarily relied on the number of respiratory events Hypothalamic inflammation pertains to the involvement
recorded on PSG, which included obstructive apnea, of hypothalamic neurons or non-neuronal cells in the
mixed apnea, hypopnea, and effort-related arousal. It is activation of pro-inflammatory signals . An animal
[39]
worth noting that depressive disorders are associated with study has demonstrated a link between a high-fat diet
an increased incidence of AHI and reduced blood oxygen and increased hypothalamic inflammation . Such a diet
[40]
saturation. These effects may be related to share underlying can directly trigger hypothalamic inflammation, while
factors, including dysfunction of the hypothalamic- chronic peripheral inflammation is known to instigate
pituitary-adrenal (HPA) axis, insulin resistance, and metabolic abnormalities . Hypothalamic inflammation,
[41]
immune inflammation activation. In addition, depressive in turn, can disrupt energy balance, enhance insulin
disorders exacerbate the use of oxygen therapy in obese and leptin resistance, and promote the accumulation of
middle-aged men. The ODI is closely related to the AHI. fat in adjacent tissues, resulting in the development of
A higher ODI corresponds to a higher AHI, indicating obesity . The correlation between BMI and hypothalamic
[42]
a more severe condition. Notably, depressive disorders inflammation has been affirmed in clinical trials that
exacerbate the severity of OSA. In addition, the use of employ quantitative imaging techniques to investigate
sedative and hypnotic drugs is more prevalent in obese hypothalamic inflammation . The correlation between
[21]
men with depressive disorders. However, it is essential BMI and left hypothalamic inflammation was notably
to recognize that these drugs have the potential to pronounced , aligning with our experimental findings
[22]
reduce respiratory muscle tone , which, in turn, leads and previous studies [10,43] . The previous studies have
[29]
to an increase in apnea and hypopnea events, thereby also identified a left-right asymmetry in hypothalamic
exacerbating the hypoxia associated with OSA. Therefore, function. The hypothalamus demonstrates asymmetrical
the use of benzodiazepines and opioids should be closely regulation of the HPA axis, circadian rhythm, reproductive
controlled and monitored in obese patients with OSA . system, immune system, thyroid function, and satiety
[30]
OSA and depressive disorders are two of the most status, all of which have implications for emotional
prevalent comorbidities in obese patients, sharing similar regulation. At present, while there are no reports on
[38]
clinical manifestations, such as daytime sleepiness, hypothalamic inflammation in patients with OSA , acute
inattention, irritability, and withdrawal from social sleep deprivation of any cause has been associated with
activities . Despite these shared symptoms, the increased production of two pro-inflammatory factors,
[31]
[44]
relationship between these two disorders remains unclear. IL-6 and tumor necrosis factor (TNF) . Individuals
Patients with OSA frequently exhibit depressive symptoms with OSA frequently experience periodic hypoxia due to
or disorders , with up to 30% of OSA patients experiencing impaired breathing, causing spontaneous arousals and
[32]
comorbid depressive disorders . This association may promoting inflammation. An analysis of obese patients
[33]
be a direct result of sleep disturbances or a secondary with and without OSA revealed abnormalities in cortisol
consequence influenced by the social implications of the release and HPA axis function in obese patients with OSA,
disorder . One study reported that 39% of 51 patients suggesting that OSA can lead to abnormal hypothalamic
[34]
with depression met the diagnostic criteria for OSA , with function . In this study, a positive correlation was
[45]
[35]
AHI and blood oxygen saturation serving as diagnostic established between the left H/A ratio and the OSA index.
criteria for OSA. It is important to note that a depressed This indicates the presence of hypothalamic inflammation
mood can elevate AHI, but this does not necessarily imply in obese patients with OSA and its positive correlation with
a causal relationship. In a longitudinal study, no significant OSA severity. These findings underscore the association of

Volume 2 Issue 1 (2024) 6 https://doi.org/10.36922/jcbp.1040