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Department of Neurology, HanKook University College of Medicine (글자 이태릭 크기 11)
Background & Purpose : Animal studies have suggested that serotonin is important in the maintenance of upper airway patency. Serotonergic neurons exert an excitatory effect on upper airway dilator motor neurons. Abnormalities in brain serotonergic activity have been implicated in psychiatric disorders, including depression. This study examined how depressive symptoms and selective seratonin reuptake inhibitors (SSRIs) affect sleep architecture, severity of obstructive sleep apnea (OSA) and periodic leg movements in sleep.
Methods : Polysomnograms from July 2002 to November 2002 of 190 subjects with OSA were reviewed retrospectively. Subjects were divided into depressed and non-depressed groups based on the Beck depression index (BDI) score (BDI > 10 indicative of depression). The two groups were further divided into SSRI and non-SSRI groups based on current use of SSRIs. Subjects taking antipsychotic, anxiolytic and hypnotic medications were excluded. Age, sex, Epworth Sleepiness Scale (ESS) scores, Body Mass Index (BMI) and polysomnographic data were collected. OSA severity was categorized as mild with apnea-hypopnea index (AHI), 5 - 20; moderate AHI 20 - 40; severe AHI > 40.
Results : 45 subjects (73% with depression) among 190 subjects with OSA were taking SSRIs at the time of PSG. There were no differences between groups in the sleep architecture, periodic limb movement index and periodic limb movement arousal index. Depressed patients taking SSRIs had significantly higher ESS scores and lower AHIs than non-depressed patients not taking SSRIs.
Conclusion : This study suggests that enhanced serotonergic transmission may be an effective therapy for OSA, particularly in the depressed population. Further prospective studies are required. (글자 크기 10, 500자 이내로)