Kan Parametreleri ile Uyku, Anksiyete ve Depresyon Belirtileri Arasındaki İlişki: Retrospektif Polisomnografi Çalışması

Year 2023, , 541 - 547, 25.10.2023

Fettah Eren , Faysal Duksal

https://doi.org/10.54005/geneltip.1308110

Abstract

Amaç: Anksiyete ve depresyonun uyku bozukluklaru ve birçok sistemik hastalık ile ilişkili olduğu bilinmektedir. Bu çalışmada polisomnografik kayıtlaması yapılan hastalarda anksiyete ve depresyonun uyku sırasındaki hipoksi, inflamasyon ve tiroid fonksiyonları ile ilişkisinin incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Retrospektif kesitsel, hastane tabanlı çalışmaya polisomnografi kaydı yapılan 808 hasta dahil edildi. Vücut kitle indeksi (VKI) hesaplandı. Anksiyete ve depresyon Beck anksiyete ve Beck depresyon envanteri ile değerlendirildi. Hastalar anksiyete ve depresyon skorlarına göre gruplara ayrıldı. Polisomnografi kayıtlarından apne hipopne indeksi (AHI), oksijen desaturasyonu indeksi (ODI), ve periferik oksijen saturasyonu (SaO2) elde edildi.
Bulgular: Çalışmada yaş ortalaması 47,64 ± 12,25 (18-82) yıl olan 528 (%65,3) erkek ve 280 (%34,7) kadın hasta vardı. Üç yüz yedi (%38,0) hastada depresyon saptandı. Hastaların 516 (%63,9) sında hafif, 215 (%26,6) inde orta ve 77 (%9,5)sinde ciddi derecede anksiyete vardı. Depresyon ve anksiyete şiddeti grupları ile tüm polisomnografi parametreleri arasında fark vardı (p=0.001). Depresyon hastalarında serbest-T3 daha düşük, C-reaktif protein (CRP) daha yüksekti (p=0.001, p=0.014). Depresyon şiddetine göre TSH ve FT4 seviyesi farkı belirlendi (p=0.037, p=0.047). Şiddetli anksiyetede CRP yüksek, orta ve şiddetli anksiyetede serbest-T3 daha düşüktü (p=0.008, p=0.003, p=0.001). Lojistik regresyon analizinde serbest-T3, minimum SaO2 ve VKI değerlerinin anksiyete (p=0.002, p=0.033, p=0.031) ve depresyon (p=0.001, p=0.017, p=0.035) üzerinde etkisi vardı.
Sonuç: Anksiyete ve depresyon uyku karakteri başta olmak üzere birçok faktörden etkilenmektedir. Özellikle minimum SaO2, CRP ve serbest-T3 bunların başında gelmektedir.

Keywords

Anksiyete, depresyon, uyku, inflamasyon, tiroid fonksiyonu

The Relationship Between Blood Parameters, Sleep, Anxiety and Depression Symptoms: A Retrospective Polysomnography Study

Abstract

Objective: It is known that anxiety and depression are associated with sleep disorders and many systemic diseases. This study aims to analyse the relationship between anxiety, depression symptoms and sleep parameters among the patients subjected to polysomnographic recording.
Material and Methods: A total of 808 patients who were subjected to a polysomnographic recording were included in the retrospective cross-sectional and hospital-based study. Body mass index (BMI) was calculated. Anxiety and depression symptoms were evaluated using the Beck anxiety and Beck depression inventory. Patients were divided into groups according to anxiety and depression scores. The apnoea hypopnea index (AHI), oxygen desaturation index (ODI), and peripheral oxygen saturation (SaO2) were obtained from the polysomnographic recordings.
Results: In the study, there were 528 (65.3%) male and 280 (34.7%) female patients with the mean age 47.64 ± 12.25 (18-82). Depression was detected in 307 (38.0%) patients according to Beck depression score. Mild anxiety symptoms were detected in 516 (63.9%), moderate anxiety symptoms in 215 (26.6%) patients and severe anxiety symptoms in 77 (9.5%) patients according to Beck anxiety score. There was a statistical difference for all polysomnographic parameters in depression and anxiety severity groups (p=0.001). In patients with depression had lower free-T3 and higher C-reactive protein (CRP) levels (p=0.001, p=0.014). The difference between thyroid stimulating hormone (TSH) and FT4 levels was determined according to the severity of the depression (p=0.037, p=0.047). CRP was higher in patients with severe anxiety (p=0.008); and free-T3 was lower in patients with moderate and severe anxiety (p=0.003, p=0.001). In the logistic regression analysis, free-T3, minimum SaO2 and BMI had an impact on anxiety (p=0.002, p=0.033, p=0.031) and depression (p=0.001, p=0.017, p=0.035).
Conclusion: Anxiety and depression symptoms are affected by numerous factors, especially sleep characteristics. Minimum SaO2, CRP and free-T3 are main predisposing factors on anxiety and depression

Keywords

Anxiety, depression, sleep, inflammation, thyroid function

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