阻塞性睡眠呼吸暂停病人心理韧性在白日嗜睡与抑郁间的调节效应

Moderating effect of resilience on excessive daytime sleepiness and depression in patients with obstructive sleep apnea

目的:探讨阻塞性睡眠呼吸暂停病人白日嗜睡、抑郁、心理韧性间的关系。方法:选择在北京大学第三医院睡眠医学中心就诊的346例阻塞性睡眠呼吸暂停病人,采用一般资料问卷、Epworth嗜睡量表、中文版Connor-Davidson心理韧性量表、Carroll抑郁量表、明尼苏达多项人格测试L量表进行调查,分析白日嗜睡、抑郁、心理韧性之间的关系。结果:346例阻塞性睡眠呼吸暂停病人中,白日嗜睡检出率为22.5%,抑郁检出率为41.3%;心理韧性以及坚韧性、力量性、乐观性与抑郁呈负相关(P<0.01),嗜睡与抑郁呈正相关(P<0.01);白日嗜睡可以直接正向预测抑郁,心理韧性中力量性调节了白日嗜睡对抑郁的直接作用,低力量性阻塞性睡眠呼吸暂停病人白日嗜睡正向预测病人抑郁水平。结论:阻塞性睡眠呼吸暂停病人白日嗜睡与抑郁症状相关;心理韧性中力量性在白日嗜睡与抑郁间起调节效应。改善白日嗜睡状况有助于改善病人的抑郁症状,提高心理韧性水平有助于减轻阻塞性睡眠呼吸暂停病人白日睡睡导致的抑郁症状。

Objective:To investigate the relationship between excessive daytime sleepiness(EDS),depression,and resilience in patients with obstructive sleep apnea(OSA).Methods:A total of 346 patients with OSA from the Sleep Medicine Center of Peking University Third Hospital were selected.General information questionnaire,Epworth Sleepiness Scale(ESS),Chinese version of Connor-Davidson Resilience Scale-25(CD-RISC-25),Carroll Rating Scale for Depression(CRS),Minnesota Multiphasic Personality Inventory(MMPI)were used to investigate the relationship between EDS,depression,and resilience indicators.Results:Among 346 patients with OSA,the detection rate of EDS was 22.5%,and the detection rate of depression was 41.3%;resilience,tenacity,strength,and optimism were negatively correlated with depression(P<0.01),and EDS was positively correlated with depression(P<0.01);EDS could directly and positively predict depression,strength in resilience moderated the direct effect of EDS on depression,and EDS in patients with low-power OSA positively predicted depression levels.Conclusions:EDS is associated with depressive symptoms in patients with OSA;strength in resilience plays a moderating effect between EDS and depression.Improving EDS could improve the depressive symptoms of patients,and improving the level of resilience could help reduce the depressive symptoms caused by EDS in patients with OSA.