Backgrounds and Objectives: There is a link between sleep apnea syndrome (OSA) and depressive and anxiety symptoms, but the underlying mechanisms are not fully understood. The study aimed to determine the prevalence of these symptoms in patients with OSA and to evaluate the impact of continuous positive airway pressure (CPAP) on depression and anxiety scores. Materials and Methods: Ninety-nine consecutive new patients diagnosed with moderate or severe (apnea-hypopnea index AHI ≥ 15 events/h) OSA were accepted for the CPAP therapy. Patients completed a patient health questionnaire (PHQ-9) for depressive symptoms and a generalized anxiety questionnaire (GAD-7) for anxiety symptoms before the CPAP treatment, after 6 months, and after 1 year of CPAP therapy with compliance. For both scores (PHQ-9 and GAD-7), a cut point ≥10 was used to indicate the presence of clinically depressive and anxiety symptoms. Results: Forty-eight individuals (48.48%) had PHQ-9 scores above the cut-off point ≥ 10, and twenty-seven participants (27.27%) had GAD-7 scores above the cut-off point ≥10. A significant correlation has been shown between PHQ-9 score and BMI (p < 0.0001), AHI (p < 0.0001), ODI (p < 0.001), ESS (p < 0.001), GAD-7 score (p < 0.0001), and [t90] (p < 0.0001), while GAD-7 was correlated with AHI (p < 0.030), ODI (p < 0.006), and [t90] (p < 0.001). The PHQ-9 and GAD-7 scores decreased significantly after 6 months of CPAP therapy in all groups and after 1 year of CPAP use. Conclusions: OSA patients should be screened for depression and anxiety. Furthermore, CPAP should be the first choice of treatment before starting other treatments for depression and anxiety symptoms.
Background: Obstructive sleep apnea increases (OSA) cognitive impairment risk. The objective of this study was to determine the impact of continuous positive airway pressure (CPAP) adherence on global cognition using the Montreal Cognitive Assessment questionnaire (MoCA). Materials and Methods: Thirty-four new patients diagnosed with moderate or severe OSA (apnea-hypopnea index AHI ≥ 15 events/h) from the CPAP group were compared with thirty-one moderate to severe OSA patients from the no-CPAP group. In addition, all patients completed the MoCA test, a patient health questionnaire (PHQ-9) for depressive symptoms, and a generalized anxiety questionnaire (GAD-7) for anxiety symptoms, at baseline, after 6 months, and after 1 year. Results: At baseline, there were no significant differences between the two groups regarding total MoCA scores, 20.9 ± 3.5 CPAP group to 19.7 ± 2.9 no-CPAP group (p = 0.159), PHQ-9 (p = 0.651), and GAD-7 (p = 0.691). After one year, improvement was observed for a total MoCA score of 22.7 ± 3.5 (p < 0.001) for the CPAP group, and significant variance of score between groups was more accentuated for delayed recall and attention (p < 0.001) sub-topic. Moreover, PHQ-9, GAD-7 scores, and the Epworth Sleepiness Scale (ESS) decreased significantly (p < 0.001) after CPAP therapy. The MoCA score was significantly correlated with years of education (r = 0.74, p < 0.001) and had a negative correlation with body mass index (BMI) (r = −0.34), ESS (r = −0.30) and PHQ-9 (r = −0.34). Conclusions: One year of CPAP adherence improved global cognition associated with OSA.
The role of chronic inflammation in the initiation and progression of carcinogenesis has been well-established in previous studies, particularly in the stages of malignant conversion, invasion, and metastasis. This study aimed to explore the potential correlation between the levels of cytokines in serum and bronchoalveolar lavage fluid (BALF) by comparing their levels between patients with lung cancer and those with benign lung diseases. The study measured the concentration of IFN-γ, TNF-α, IL-1β, IL-2, IL-4, IL-6, IL-10, and IL-12p70, in venous blood and BALF of a total of 33 patients with lung cancer and 33 patients with benign lung diseases. Significant differences were found between the two groups in various clinical parameters. The cytokine levels were significantly higher among patients with malignant disease, while the BALF analysis revealed higher cytokine levels compared with serum analysis. It was discovered that the levels of cancer-specific cytokines in the lavage fluid increased significantly sooner and were present at a greater concentration than those in the peripheral blood. After one month of treatment, the serum markers decreased significantly but slower in the lavage fluid. The differences between serum and BALF markers remained significant. It was observed that the highest correlation was among IL-6 (serum) and IL-6 (lavage), with a coefficient of 0.774 (p-value < 0.001), and IL-1 (serum) and IL-1β (lavage), with a coefficient value of 0.610 (p-value < 0.001). Other significant correlations among serum and lavage cytokines were observed between IL-6 (lavage) and IL-1 (serum) (rho = 0.631, p-value < 0.001) and CRP (rho = 0.428, p-value = 0.001), respectively. This study revealed significant differences and correlations in clinical parameters, serum markers, and BALF inflammatory markers between patients with lung cancer and those with benign lung pathologies. The results highlight the importance of understanding the inflammatory profiles of these conditions and could contribute to the development of targeted therapies or diagnostic approaches in the future. Further research is needed to validate these findings, explore their implications for clinical practice, and determine the diagnostic and prognostic value of these cytokines for lung cancer.
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