Mood disorders are highly prevalent in patients investigated with a multiple sleep latency test

The prevalence of anxiety in respiratory and sleep diseases: A systematic review and meta-analysis

BACKGROUND

Anxiety is common in those with chronic physical health conditions and can have significant impacts on both quality of life and physical health outcomes. Despite this, there are limited studies comprehensively investigating the prevalence of anxiety in respiratory and sleep medicine settings. This systematic review and meta-analysis aims to provide insight into the global prevalence of anxiety symptoms/disorders in respiratory and sleep medicine outpatients.

METHODS

PubMed, Embase, Cochrane, PsycINFO and Google Scholar databases were searched from database inception to January 23, 2023 for studies assessing the prevalence of anxiety in adult (≥16 years) respiratory and sleep medicine outpatients. Data was screened and extracted independently by two investigators. Anxiety was measured using various self-report questionnaires, structured interviews, and/or patient records. Using CMA software for the meta-analysis, a random-effects model was used for pooled estimates, and subgroup analysis was conducted on relevant models using a mixed-effects model.

RESULTS

116 studies were included, featuring 36,340 participants across 40 countries. The pooled prevalence of anxiety was 30.3 % (95%CI 27.9-32.9 %, 10,679/36,340). Subgroup analysis found a significant difference across type of condition, with pulmonary tuberculosis the highest at 43.1 % and COVID-19 outpatients the lowest at 23.4 %. No significant difference was found across anxiety types, country or age. Female sex and the use of self-report measures was associated with significantly higher anxiety estimates.

CONCLUSIONS

Anxiety is a common experience amongst patients in respiratory and sleep medicine outpatient settings. Thus, it is crucial that anxiety identification and management is considered by physicians in the field.

REGISTRATION

The protocol is registered in PROSPERO (CRD42021282416).

Magnetic resonance imaging in mood disorders: a bibliometric analysis from 1999 to 2020

Objective

Globally, mood disorders are highly prevalent, and are associated with increased morbidity and mortalities. Magnetic resonance imaging is widely used in the study of mood disorders. However, bibliometric analyses of the state of this field are lacking.

Methods

A literature search in the web of science core collection (WoSCC) for the period between 1945 and 2020 returned 3073 results. Data extracted from these publications include, publication year, journal names, countries of origin, institutions, author names and research areas. The bibliometric method, CiteSpace V and key words analysis were used to visualize the collaboration network and identify research trends, respectively.

Results

Since it was first reported in 1999, the use of magnetic resonance imaging in studies on mood disorders has been increasing. Biological psychiatry is the core journal that has extensively published on this topic, while the UNIV PITTSBURGH, USA, has the highest published papers on this topic. Keyword analysis indicated that studies on depression, bipolar disorders, and schizophrenia, with a focus on specific brain regions, including amygdala, prefrontal cortex and anterior cingulate cortex are key research topics.

Conclusion

Brain structure and network, sex differences, and treatment-associated brain changes are key topics of future research.

Age-Related Differences in Mood, Diabetes-Related Distress, and Functional Outcomes in Adults With Type 2 Diabetes Mellitus and Comorbid Obstructive Sleep Apnea and Insomnia

PURPOSE

The purpose of this study was to examine age-related differences in mood, diabetes-related distress, and functional outcomes in activities sensitive to impaired sleep in adults with type 2 diabetes mellitus (T2DM) and comorbid obstructive sleep apnea (OSA) and insomnia. This study also evaluated the associations of age, insomnia severity, and OSA severity on outcome variables.

METHODS

This study was a secondary analysis of pooled baseline data from 2 randomized controlled trials among adults with T2DM with symptoms of sleep disorders (N = 145,109 younger adults, 36 older adults; 46.2% male; 67.6% white). Comorbid OSA and insomnia was defined as Apnea-Hypopnea Index ≥5 events per hour and Insomnia Severity Index ≥10. Outcome variables included mood, diabetes-related distress, and functional outcomes.

RESULTS

Older adults reported better mood, lower diabetes-related distress, and higher functional outcomes relative to younger adults (all Ps < .05). Insomnia severity was associated with worse mood (b = 2.59, P < .001) and diabetes-related distress (b = 1.40, P < .001) and lower functional outcome (b = -0.22, P < .001). Older age was associated with lower diabetes-related distress (b = -0.44, P = .040).

CONCLUSION

Older age was a protective factor of mood disturbance, diabetes-related distress, and functional impairment in adults with T2DM and comorbid OSA and insomnia. Insomnia severity was associated with greater mood disturbance, diabetes-related distress, and functional impairment when OSA and insomnia coexist. The results suggest that diabetes care and education specialists should assess patients for impaired sleep.

Reported and Recorded Sleepiness in Obesity and Depression

BACKGROUND

Obesity and depression are both associated with changes in sleep/wake regulation, with potential implications for individualized treatment especially in comorbid individuals suffering from both. However, the associations between obesity, depression, and subjective, questionnaire-based and objective, EEG-based measurements of sleepiness used to assess disturbed sleep/wake regulation in clinical practice are not well known.

OBJECTIVES

The study investigates associations between sleep/wake regulation measures based on self-reported subjective questionnaires and EEG-derived measurements of sleep/wake regulation patterns with depression and obesity and how/whether depression and/or obesity affect associations between such self-reported subjective questionnaires and EEG-derived measurements.

METHODS

Healthy controls (HC, N_HC = 66), normal-weighted depressed (DEP, N_DEP = 16), non-depressed obese (OB, N_OB = 68), and obese depressed patients (OBDEP, N_OBDEP = 43) were included from the OBDEP (Obesity and Depression, University Leipzig, Germany) study. All subjects completed standardized questionnaires related to daytime sleepiness (ESS), sleep quality and sleep duration once as well as questionnaires related to situational sleepiness (KSS, SSS, VAS) before and after a 20 min resting state EEG in eyes-closed condition. EEG-based measurements of objective sleepiness were extracted by the VIGALL algorithm. Associations of subjective sleepiness with objective sleepiness and moderating effects of obesity, depression, and additional confounders were investigated by correlation analyses and regression analyses.

RESULTS

Depressed and non-depressed subgroups differed significantly in most subjective sleepiness measures, while obese and non-obese subgroups only differed significantly in few. Objective sleepiness measures did not differ significantly between the subgroups. Moderating effects of obesity and/or depression on the associations between subjective and objective measures of sleepiness were rarely significant, but associations between subjective and objective measures of sleepiness in the depressed subgroup were systematically weaker when patients comorbidly suffered from obesity than when they did not.

CONCLUSION

This study provides some evidence that both depression and obesity can affect the association between objective and subjective sleepiness. If confirmed, this insight may have implications for individualized diagnosis and treatment approaches in comorbid depression and obesity.