阻塞性睡眠呼吸暂停与抑郁症共病机制的研究进展

doi:10.6040/j.issn.1673-3770.0.2024.513

摘要/Abstract

摘要： 阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)是一种常见的睡眠呼吸障碍疾病。抑郁症也称抑郁障碍,是一种常见的精神障碍。OSA与抑郁症相互影响,OSA患者的抑郁症患病率较高,睡眠结构紊乱、日间疲劳以及周围人对患者鼾声的负面评价影响了OSA患者的情绪;而抑郁症患者常伴有OSA相关的睡眠障碍,可能通过异常的神经递质和呼吸道肌张力,加重患OSA的风险。两种疾病同时存在时往往症状更严重、治疗也更加复杂,两者的共同发病机制包括神经炎症、氧化应激、肠道菌群紊乱、突触可塑性受损、5-羟色胺水平改变和补体系统激活。这些机制在OSA与抑郁症的发生与发展过程中相互作用,共同推动疾病的进展。本综述从OSA与抑郁症共病的流行病学、潜在机制及治疗策略出发,旨在加深临床对两者共病的认识,为患者的个性化治疗方案提供科学依据。

关键词: 阻塞性睡眠呼吸暂停, 抑郁症, 共病, 神经炎症

Abstract: Obstructive sleep apnea(OSA)is a common sleep-related breathing disorder. Depression, also known as depressive disorder, is a prevalent mental disorder. OSA and depression interact with each other. Patients with OSA have a higher prevalence of depression, as poor sleep structure, daytime fatigue and complaints from others about snoring negatively affect the mood of OSA patients; patients with depression frequently experience sleep disturbances, which may increase the risk of OSA through abnormal neurotransmitter levels and altering muscle tone. Moreover, co-occurrence of these disorders often manifests as more severe symptomatology and complex therapeutic challenges. Shared pathophysiological mechanisms include neuroinflammation, oxidative stress, gut microbiota dysbiosis, impaired synaptic plasticity, lower 5-HT levels, and complement activation. These mechanisms interact in the occurrence and development of OSA and depression, and jointly promote the progression of the disease. In this paper, we summarize the epidemiology, pathogenesis, and treatment of OSA and depression comorbidity, aiming to deepen the understanding of the two co-comorbidities and to provide scientific support for precise treatment of patients.

Key words: Obstructive sleep apnea, Depression, Comorbidity, Neuroinflammation

中图分类号:

R766

李莉琳,李馨仪,关建. 阻塞性睡眠呼吸暂停与抑郁症共病机制的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 89-96.

LI Lilin, LI Xinyi, GUAN Jian. Research progress on the mechanism of comorbidity between obstructive sleep apnea and depression[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 89-96.

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