Hayun Choi, Gia Han Le, Kayla M Teopiz, Rodrigo B Mansur, Joshua D Rosenblat, Sabrina Wong, Seonjeong Byun, Roger S McIntyre
{"title":"评估阻塞性睡眠呼吸暂停伴失眠症患者的自杀意念和快感缺乏症状。","authors":"Hayun Choi, Gia Han Le, Kayla M Teopiz, Rodrigo B Mansur, Joshua D Rosenblat, Sabrina Wong, Seonjeong Byun, Roger S McIntyre","doi":"10.1177/08919887251338262","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveInsomnia and obstructive sleep apnea (OSA) are prevalent in the geriatric population, with co-morbid insomnia and sleep apnea (COMISA) increasing the risk of suicidal ideation. Anhedonia, a core depression feature, is associated with suicidal ideation. This study aimed to explore the relationship between COMISA and suicidality including the mediating effect of anhedonic symptoms.MethodsFrom August 2021 to December 2023, 243 participants from South Korea were enrolled in a prospective case-control study at a Veterans' hospital. Participants underwent interviews, self-report measures, and polysomnography. 214 untreated OSA participants were categorized into COMISA and OSA-only groups. Anhedonic symptoms and their correlates were investigated.Results69 participants (32.2%) had an Insomnia Severity Index score >15, forming the COMISA group. Suicidal ideation was more prevalent in the COMISA group (43.1% vs 23.4%, <i>P</i> = 0.007). After adjusting for covariates such as age, gender, body mass index, alcohol and smoking consumption, caffeine intake, hypertension, diabetes mellitus, and sleep-related factors, the odds of suicidal ideation were higher in the COMISA group (OR = 2.42, 95% CI = 1.14 - 5.11). However, after adjusting for anhedonic symptoms, this association was no longer significant. Anhedonic symptoms mediated the relationship between insomnia and suicidal ideation (OR = 1.045, 95% CI = 1.013-1.074).ConclusionsThe findings of this study underscore the emergence of suicidal ideation among individuals with COMISA. Understanding the mechanisms of anhedonic symptoms underlying the relationship between COMISA and suicidal ideation is crucial for developing targeted interventions to mitigate suicidality in this population.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"8919887251338262"},"PeriodicalIF":2.9000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating Suicidal Ideation and Anhedonic Symptoms in Obstructive Sleep Apnea Patients with Insomnia.\",\"authors\":\"Hayun Choi, Gia Han Le, Kayla M Teopiz, Rodrigo B Mansur, Joshua D Rosenblat, Sabrina Wong, Seonjeong Byun, Roger S McIntyre\",\"doi\":\"10.1177/08919887251338262\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>ObjectiveInsomnia and obstructive sleep apnea (OSA) are prevalent in the geriatric population, with co-morbid insomnia and sleep apnea (COMISA) increasing the risk of suicidal ideation. Anhedonia, a core depression feature, is associated with suicidal ideation. This study aimed to explore the relationship between COMISA and suicidality including the mediating effect of anhedonic symptoms.MethodsFrom August 2021 to December 2023, 243 participants from South Korea were enrolled in a prospective case-control study at a Veterans' hospital. Participants underwent interviews, self-report measures, and polysomnography. 214 untreated OSA participants were categorized into COMISA and OSA-only groups. Anhedonic symptoms and their correlates were investigated.Results69 participants (32.2%) had an Insomnia Severity Index score >15, forming the COMISA group. Suicidal ideation was more prevalent in the COMISA group (43.1% vs 23.4%, <i>P</i> = 0.007). After adjusting for covariates such as age, gender, body mass index, alcohol and smoking consumption, caffeine intake, hypertension, diabetes mellitus, and sleep-related factors, the odds of suicidal ideation were higher in the COMISA group (OR = 2.42, 95% CI = 1.14 - 5.11). However, after adjusting for anhedonic symptoms, this association was no longer significant. Anhedonic symptoms mediated the relationship between insomnia and suicidal ideation (OR = 1.045, 95% CI = 1.013-1.074).ConclusionsThe findings of this study underscore the emergence of suicidal ideation among individuals with COMISA. Understanding the mechanisms of anhedonic symptoms underlying the relationship between COMISA and suicidal ideation is crucial for developing targeted interventions to mitigate suicidality in this population.</p>\",\"PeriodicalId\":16028,\"journal\":{\"name\":\"Journal of Geriatric Psychiatry and Neurology\",\"volume\":\" \",\"pages\":\"8919887251338262\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-05-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Geriatric Psychiatry and Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/08919887251338262\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Geriatric Psychiatry and Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08919887251338262","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:失眠和阻塞性睡眠呼吸暂停(OSA)在老年人群中普遍存在,合并失眠和睡眠呼吸暂停(COMISA)增加了自杀意念的风险。快感缺乏是抑郁症的核心特征,与自杀意念有关。本研究旨在探讨COMISA与自杀的关系,包括快感缺乏症状的中介作用。方法从2021年8月到2023年12月,243名来自韩国的参与者在一家退伍军人医院参加了一项前瞻性病例对照研究。参与者接受了访谈、自我报告测量和多导睡眠描记仪。214名未经治疗的OSA参与者分为COMISA组和单纯OSA组。研究了快感缺乏症状及其相关因素。结果69例(32.2%)失眠严重程度指数评分为bb15分,构成COMISA组。自杀意念在COMISA组更为普遍(43.1% vs 23.4%, P = 0.007)。在调整协变量如年龄、性别、体重指数、饮酒和吸烟、咖啡因摄入、高血压、糖尿病和睡眠相关因素后,COMISA组自杀意念的几率更高(OR = 2.42, 95% CI = 1.14 - 5.11)。然而,在对快感缺乏症状进行调整后,这种关联不再显著。快感缺乏症状介导失眠与自杀意念的关系(OR = 1.045, 95% CI = 1.013-1.074)。结论本研究结果强调了COMISA患者出现自杀意念的可能性。了解COMISA与自杀意念之间关系的快感缺乏症状机制对于制定有针对性的干预措施以减轻这一人群的自杀行为至关重要。
Evaluating Suicidal Ideation and Anhedonic Symptoms in Obstructive Sleep Apnea Patients with Insomnia.
ObjectiveInsomnia and obstructive sleep apnea (OSA) are prevalent in the geriatric population, with co-morbid insomnia and sleep apnea (COMISA) increasing the risk of suicidal ideation. Anhedonia, a core depression feature, is associated with suicidal ideation. This study aimed to explore the relationship between COMISA and suicidality including the mediating effect of anhedonic symptoms.MethodsFrom August 2021 to December 2023, 243 participants from South Korea were enrolled in a prospective case-control study at a Veterans' hospital. Participants underwent interviews, self-report measures, and polysomnography. 214 untreated OSA participants were categorized into COMISA and OSA-only groups. Anhedonic symptoms and their correlates were investigated.Results69 participants (32.2%) had an Insomnia Severity Index score >15, forming the COMISA group. Suicidal ideation was more prevalent in the COMISA group (43.1% vs 23.4%, P = 0.007). After adjusting for covariates such as age, gender, body mass index, alcohol and smoking consumption, caffeine intake, hypertension, diabetes mellitus, and sleep-related factors, the odds of suicidal ideation were higher in the COMISA group (OR = 2.42, 95% CI = 1.14 - 5.11). However, after adjusting for anhedonic symptoms, this association was no longer significant. Anhedonic symptoms mediated the relationship between insomnia and suicidal ideation (OR = 1.045, 95% CI = 1.013-1.074).ConclusionsThe findings of this study underscore the emergence of suicidal ideation among individuals with COMISA. Understanding the mechanisms of anhedonic symptoms underlying the relationship between COMISA and suicidal ideation is crucial for developing targeted interventions to mitigate suicidality in this population.
期刊介绍:
Journal of Geriatric Psychiatry and Neurology (JGP) brings together original research, clinical reviews, and timely case reports on neuropsychiatric care of aging patients, including age-related biologic, neurologic, and psychiatric illnesses; psychosocial problems; forensic issues; and family care. The journal offers the latest peer-reviewed information on cognitive, mood, anxiety, addictive, and sleep disorders in older patients, as well as tested diagnostic tools and therapies.