Key result
Major depressive disorder is linked to ~20% higher respiratory sinus arrhythmia phase coherence in OSA.
Why the study?
Depression is frequently misdiagnosed when concurrent with obstructive sleep apnea due to overlapping symptoms, and whether phase coherence between respiratory sinus arrhythmia and respiration differs in OSA patients with versus without MDD was unknown.
Does major depressive disorder affect phase coherence between respiratory sinus arrhythmia and respiration during sleep in patients with obstructive sleep apnea?
Cross-Sectional (n=118)
Yes
Does major depressive disorder affect phase coherence between respiratory sinus arrhythmia and respiration during sleep in patients with obstructive sleep apnea?
Absolute Event Rate: 0.67% vs 0.56%
p-value: p=<0.001
Depression in OSA patients is associated with increased phase synchronization between respiratory sinus arrhythmia and respiration, suggesting lowered sympathetic activity.
MDD-associated increase in RSA-respiration coherence in OSA is hypothesis-generating; leaves open autonomic mechanisms and clinical relevance pending longitudinal data.
Introduction: A high prevalence of major depressive disorder (MDD) among Obstructive Sleep Apnea (OSA) patients has been observed in both community and clinical populations. Due to the overlapping symptoms between both disorders, depression is usually misdiagnosed when correlated with OSA. Phase coherence between respiratory sinus arrhythmia (RSA) and respiration (λ RSA-RESP ) has been proposed as an alternative measure for assessing vagal activity. Therefore, this study aims to investigate if there is any difference in λ RSA-RESP in OSA patients with and without MDD. Methods: Electrocardiograms (ECG) and breathing signals using overnight polysomnography were collected from 40 OSA subjects with MDD (OSAD+), 40 OSA subjects without MDD (OSAD-), and 38 control subjects (Controls) without MDD and OSA. The interbeat intervals (RRI) and respiratory movement were extracted from 5-min segments of ECG signals with a single apneic event during non-rapid eye movement (NREM) [353 segments] and rapid eye movement (REM) sleep stages [298 segments]. RR intervals (RRI) and respiration were resampled at 10 Hz, and the band passed filtered (0.10–0.4 Hz) before the Hilbert transform was used to extract instantaneous phases of the RSA and respiration. Subsequently, the λ RSA-RESP between RSA and Respiration and Heart Rate Variability (HRV) features were computed. Results: Our results showed that λ RSA-RESP was significantly increased in the OSAD+ group compared to OSAD- group during NREM and REM sleep. This increase was accompanied by a decrease in the low frequency (LF) component of HRV. Discussion: We report that the phase synchronization index between RSA and respiratory movement could provide a useful measure for evaluating depression in OSA patients. Our findings suggest that depression has lowered sympathetic activity when accompanied by OSA, allowing for stronger synchronization between RSA and respiration.
No takes yet. Share an insight, caveat, or question.
Alzaabi et al. (2023) conducted a cross-sectional in Obstructive Sleep Apnea and Major Depressive Disorder (n=118). Major Depressive Disorder (MDD) vs. OSA without MDD was evaluated on Phase coherence between respiratory sinus arrhythmia and respiration (λ) during NREM sleep (p=<0.001). Major depressive disorder significantly increased phase coherence between respiratory sinus arrhythmia and respiration in patients with obstructive sleep apnea during NREM and REM sleep.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: