Zhongguo quanke yixue (Nov 2022)

Effect of Depressive Symptoms on the Adherence to Continuous Positive Airway Pressure in Obstructive Sleep Apnea Patients Using a Path Analysis-based Approach

  • YI Huijie, LI Jianxiang, ZHANG Chi, XU Liyue, DONG Xiaosong, HAN Fang

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0265
Journal volume & issue
Vol. 25, no. 33
pp. 4179 – 4184

Abstract

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Background The treatment adherence is closely related to the effect of continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea (OSA) , which is also strongly influenced by patients' psychosocial characteristics. However, the influence of depression symptoms on the adherence to CPAP needs to be further explored. Objective To evaluate the relationship of depression symptoms with adherence to CPAP, and the pathwaybetween the associated factors in OSA patients. Methods A total of 177 patients who were diagnosed with OSA and treated with CPAP in the Respiratory and Sleep Medicine Center, Peking University People's Hospital from May 2019 to July 2021 were selected. The general information, disease severity and adherence to CPAP were evaluated. The prevalence of depression symptoms was measured by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) . The severity of insomnia was assessed by the Insomnia Severity Index (ISI) . The influence of daytime sleepiness on activities of daily living was measured by the 10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10) . The 12-item Short Form Health Survey (SF-12) was used to evaluate the quality of life. The relationships among variables were determined by path analysis. Results The prevalence of depressive symptoms in OSA patients was relatively high (19.7%, 35/177) in our study. Depression symptoms were associated with increased insomnia prevalence (r=0.65, P<0.05) , and decreased levels of activities of daily living (r=-0.51, P<0.05) and quality of life (rPCS=-0.27, P<0.05; rMCS=-0.72, P<0.05) . In addition, depressive symptoms had no relationship on the adherence to CPAP (r=0.09, P>0.05) , but could increase the adherence to CPAP by decreasing the activities of daily living (β=0.078, P<0.01) . Conclusion Depressive symptoms were significantly associated with insomnia, decreased quality of life and activities of daily living in OSA patients, and could increase patients' adherence to CPAP through decreasing the activities of daily living.

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