Obstructive Sleep Apnea and the Subsequent Risk of Depressive Disorder: A Population-Based Follow-up Study

Chen, Yi Hua; Keller, Joseph J.; Kang, Jiunn Horng; Hsieh, Heng Ju; Lin, Herng Ching

doi:10.5664/jcsm.2652

Cited by 115 publications

(83 citation statements)

References 38 publications

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“…otorrhea and hearing loss) are generally referred for further otolaryngologic examination, such that cholesteatoma is theoretically diagnosed or confirmed by an otolaryngologist. Furthermore, in Taiwan, only psychiatrists are permitted to make a diagnosis of DD [9]. Despite these strengths, findings in this study should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 87%

“…First, an epidemiological association does not necessarily imply biological causation. In this study, we analyzed newly diagnosed cholesteatoma patients to avoid the potential effects of chronicity [9]. It should be noted however, that some of these cases may not have been newly developed.…”

Section: Discussionmentioning

confidence: 99%

“…First, DD has been implicated in poor adherence to medical treatment [6,9,15]. Poor follow-up compliance is a major concern of surgeons, even in cases where cholesteatoma has been entirely eradicated, due to the difficulties associated with post-operative recidivism, particularly the need for repeated revision surgeries [16].…”

Section: Discussionmentioning

confidence: 99%

“…To validate the completeness and accuracy of the claims data, the NHRI conducts random patient interviews, annually reviews medical records, and employs random sampling of claims from every hospital. Hundreds of researchers have previously employed NHI data in peer-reviewed research [8,9].…”

Section: Data Sourcementioning

confidence: 99%

See 3 more Smart Citations

Increased Risk of Depression in Patients with Cholesteatoma: A 3-year Nationwide Population-Based Retrospective Cohort Study

Kuo

Chang

et al. 2017

AOHNS

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Data Sourcementioning

confidence: 99%

See 2 more Smart Citations

Increased Risk of Depression in Patients with Cholesteatoma: A 3-year Nationwide Population-Based Retrospective Cohort Study

Kuo

Chang

et al. 2017

AOHNS

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“…It has been discussed that OSA decreases the percentage of REM sleep, which results in dysfunction of brain circuitry related to emotion and mood regulation. Indeed, a few inhibitory and excitatory neurotransmitters, such as serotonin, norepinephrine, and γ-aminobutyric acid (GABA), alter the function of key regions involved in both sleep/wake cycle and mood regulation (46). Therefore, the imbalance of neurotransmitters might lead to cooccurrence of MDD and OSA.…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 99%

Higher Risk for Obstructive Sleep Apnea in Chronic Treatment-Resistant Depression

Khazaie

Alavi-Mehr

Younesi

et al. 2018

Iran J Psychiatry Behav Sci

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Objectives: Studies have reported a higher risk for obstructive sleep apnea (OSA) in major depressive disorder (MDD). However, the risk of OSA in patients with chronic treatment-resistant depressive symptoms is not well documented worldwide. Hence, the current study assessed the risk of OSA and associated factors in patients with chronic treatment resistant depression (cTRD). Methods: The study recruited 140 Iranian patients with cTRD. All patients completed the Berlin questionnaire, which evaluates the risk of OSA. Additionally, demographic data and history of cardiovascular or metabolic diseases were collected. Pearson's Chi-square test, Fisher's exact test, and independent T-test were used to assess group differences, when appropriate. Results: The study found that 89 of 140 cTRD patients (64%) were at high risk for OSA. Group comparison between cTRD patients (high vs. low risk for OSA) demonstrated that at high risk OSA-cTRD patients had an elevated rate of hypertension, diabetes mellitus, and obesity. Also, age, duration of depression, and duration of treatment were significantly higher in cTRD patients with higher risk compared to those with lower risk for OSA. Conclusions:The results suggest that a noticeable number of patients with cTRD are at high risk for OSA, which is higher than the reported magnitude in the general population. Moreover, hypertension, diabetes mellitus, and obesity are associated with a higher risk for OSA. Also, age, treatment duration, and depression duration could be considered as possible comorbid factors for OSA in patients with cTRD.

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Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

Kuo

Yen

Chang

et al. 2017

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Chronic rhinosinusitis (CRS) can cause an obstruction of the tubal orifice and thereby compromise ventilation of the middle ear. The resulting negative pressure in the middle ear may, in turn, lead to the formation of an eardrum retraction pocket and subsequent acquired cholesteatoma. This study hypothesizes that CRS may increase the risk of cholesteatoma. OBJECTIVE To evaluate the risk of cholesteatoma in patients with CRS. DESIGN, SETTING, AND PARTICIPANTS This study used a nationwide, population-based claims database to test the hypothesis that CRS may increase the risk of cholesteatoma. The Longitudinal Health Insurance Database of Taiwan was used to compile data from (1) 12 670 patients with newly diagnosed CRS between January 1, 1997, and December 31, 2002, and (2) a comparison cohort of 63 350 matched individuals without CRS, resulting in a CRS vs control ratio of 1:5. Data analysis was performed from June 1 to October 27, 2015. Each patient was followed up for 8 years to identify those in whom cholesteatoma subsequently developed. The Kaplan-Meier method was used to determine the cholesteatoma-free survival rate, and the log-rank test was used to compare survival curves. Cox proportional hazards regression models were used to compute the 8-year hazard ratios (HRs). MAIN OUTCOMES AND MEASURES Diagnosis of cholesteatoma. RESULTS Among the 76 020 patients enrolled in this study, 35 220 (46.3%) were female; mean (SD) age was 27.57 (22.03) years. A total of 209 patients developed cholesteatoma, 66 (101 084 person-years) individuals from the CRS cohort and 143 (506 540 person-years) from the comparison cohort were diagnosed with cholesteatoma during the 8-year follow-up period. The incidence of cholesteatoma per 1000 person-years was more than twice as high among patients with CRS (0.65; 95% CI, 0.50-0.81 person-years) than among those without CRS (0.28; 95% CI, 0.24-0.33). The absolute difference in the incidence density between CRS and non-CRS group was 0.37 (95% CI, 0.21-0.53) per 1000 patient-years. After adjusting for potential confounders, patients with CRS had a 69% increased risk of cholesteatoma within 8 years, compared with those without CRS (HR, 1.69; 95% CI, 1.23-2.32). Patients with CRS presented a significantly lower 8-year cholesteatoma-free survival rate than did those in the comparison group. The absolute difference in the 8-year cholesteatoma-free survival rate between the CRS and non-CRS groups was 0.0029 (95% CI, 0.0016-0.0043). CONCLUSIONS AND RELEVANCE This is the first large-scale study, to date, to demonstrate a prospective link between CRS and the subsequent development of cholesteatoma within a follow-up period of 8 years. The purpose of the study was to draw attention to the possibility of development of cholesteatoma among patients with CRS. Because that possibility exists, clinicians should keep this association in mind as well as the importance of a thorough head and neck examination.

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Obstructive Sleep Apnea and the Subsequent Risk of Depressive Disorder: A Population-Based Follow-up Study

Cited by 115 publications

References 38 publications

Increased Risk of Depression in Patients with Cholesteatoma: A 3-year Nationwide Population-Based Retrospective Cohort Study

Increased Risk of Depression in Patients with Cholesteatoma: A 3-year Nationwide Population-Based Retrospective Cohort Study

Higher Risk for Obstructive Sleep Apnea in Chronic Treatment-Resistant Depression

Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

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