阻塞型睡眠呼吸中止症者罹患憂鬱症之風險評估

Obstructive Sleep Apnea and The Subsequent Risk of Depressive Disorder

謝亨如(Heng-Ju Hsieh)

指導教授 ： 林恆慶

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2013年)

摘要

中文摘要
論文名稱：阻塞型睡眠呼吸中止症者罹患憂鬱症之風險評估
研究所名稱：臺北醫學大學醫務管理學研究所
研究生姓名：謝亨如
論文口試時間：一百零一學年度第二學期
指導教授：林恆慶 博士/臺北醫學大學醫務管理學研究所 教授

研究背景與目的：
從過去的文獻及研究中可知，目前學者對阻塞型睡眠呼吸中止症與憂鬱的相關性有不同看法；實證研究的結果是喜憂參半。因此，透過此一以全國性人口學為基礎之研究，評估阻塞型睡眠呼吸中止症患者罹患憂鬱症之風險。
研究方法：世代研究
研究對象：
本研究資料來源為全民健保資料庫2000年檔(LHID2000)。2002年到2008年間，2,818例患者被診斷為阻塞型呼吸睡眠中止症，與14,090名非阻塞型呼吸睡眠中止症患者之對照組進行評估。

研究結果：
自阻塞型呼吸睡眠中止症候群的診斷日起，進行為期一年的追蹤，結果發現，阻塞型呼吸睡眠中止症候群患者罹患憂鬱症的風險（18.10，95％CI=13.62-23.61），相較於非阻塞型呼吸睡眠中止者（8.23，95 ％CI=6.83-9.84）增加2.18倍以上風險。經校正相關變項之後發現：在為期一年的追蹤期間，女性實驗組（2.72，95％CI=1.68-4.40）其罹患憂鬱症的風險，比男性對照組（1.81，95％CI = 1.09-3.01）高出2.72倍之多，有顯著差異。

結論：
1.研究證實阻塞型睡眠呼吸中止症患者，未來的一年內罹患憂鬱症之關連性。
2.女性風險尤為明顯。

關鍵字：阻塞型睡眠呼吸中止症、憂鬱症、關聯性

關鍵字

阻塞型睡眠呼吸中止症 ； 憂鬱症 ； 關聯性

並列摘要

Abstract
Title of thesis：Obstructive Sleep Apnea and The Subsequent Risk of Depressive Disorder
Author：Heng - Ju Hsieh
Thesis advised by：Herng-Ching Lin,Ph.D.

Study objectives:
Empirical findings on the prospective link between obstructive sleep apnea (OSA) and subsequent depression are mixed. This nationwide, population-based study thus aimed at assessing the risk of depressive disorder within the first year following a diagnosis with OSA. Gender effects were further examined.

Design: Cohort study

Setting: Taiwan

Patients:
This study used data from the Longitudinal Health Insurance Database 2000. A total of 2,818 patients diagnosed with OSA between 2002 and 2008 were evaluated along with 14,090 matched non-OSA enrollees used as a comparison cohort.

Measurements and results:
Each patient was followed for one year to identify subsequent depressive disorder. We found that during the one-year follow-up, the incidence of depressive disorder per thousand person-years was about two times higher among patients with OSA (18.10, 95% CI=13.62-23.61) than those without OSA (8.23, 95% CI=6.83-9.84). The Cox proportional hazards model revealed that patients with OSA were independently associated with a 2.18 times (95% CI=1.55-3.08) increased risk of subsequent depressive disorder within a year, compared to those without OSA. As epidemiological studies have consistently documented an increased risk for depression in women, we hypothesized and confirmed higher risks of depressive disorder among female patients with OSA (2.72, 95% CI=1.68-4.40) than their male counterparts (1.81, 95% CI=1.09-3.01).

Conclusion:
A prospective link between OSA and subsequent depressive disorder within one year was confirmed by the current study. The risk was particularly evident among women.

Key words: obstructive sleep apnea; depressive disorder; prospective link

並列關鍵字

obstructive sleep apnea ； depressive disorder ； prospective link

參考文獻

參考文獻

中文部份

商志雍(2003)。精神科門診憂鬱症患者就診率之變遷。台灣醫學 FORMOSAN Med ，2003年7月，502-9。

陳韻玲(2009)。憂鬱症生活品質的長期追蹤研究。臺灣大學職能治療研究所學位論文。

林律瑋(2009)。睡眠呼吸中止症成本推估。臺北醫學大學醫務管理學研究所學位論文。