Vu le peu de données actuellement disponibles dans la littérature, notre objectif était d’investiguer la prévalence du syndrome d’apnées obstructives du sommeil (SAOS) chez les jeunes adultes et d’étudier le risque de SAOS associé à la dépression majeure typique et atypique dans cette sous-population particulière.

Les données de 264 jeunes adultes âgés de 18 à 30 ans ont été collectées au départ de la base de données du Laboratoire de Sommeil de l’Hôpital Erasme (Bruxelles, Belgique) afin de permettre nos analyses. Un index d’apnées-hypopnées obstructives du sommeil supérieur ou égal à cinq par heure a été utilisé pour le diagnostic de SAOS. Nous avons utilisé des analyses de régression logistique pour déterminer le risque de SAOS associé à la dépression majeure chez les jeunes adultes.

La prévalence du SAOS dans notre population de jeunes adultes était de 18,6 %. Après ajustement pour les principaux facteurs confondants associés au SAOS, les analyses de régression multivariée ont indiqué que contrairement à la dépression typique, la dépression atypique était un facteur de risque du SAOS chez les jeunes adultes.

Dans notre étude, nous avons mis en évidence que la dépression atypique était associée à un risque accru de SAOS chez les jeunes adultes, en particulier ceux adressés au laboratoire du sommeil, ce qui semble justifier une recherche plus systématique de cette pathologie chez les jeunes adultes souffrant de dépression atypique afin de permettre la mise en place de stratégies thérapeutiques adaptées et éviter les conséquences négatives associées à la survenue concomitante de ces deux pathologies.

In the literature, several studies have investigated the particular relationship between major depression and obstructive sleep apnoea syndrome (OSAS). However, most of these studies have focused primarily on middle-aged to elderly individuals (≥40 years) which means that this problem has been little studied in young adults (<30 years). Nevertheless, in young adults the prevalence of major depression (particularly its atypical subtype) is not negligible, which seems to justify carrying out additional investigations in order to allow a better understanding of the potential role played by major depression in the pathophysiology of OSAS in this particular subpopulation. The aim of this study was therefore to empirically investigate the prevalence of OSAS in young adults and to study the risk of OSAS associated with major depression in this particular subpopulation.

Polysomnographic and demographic data from 264 young adults were collected from the Erasme Hospital Sleep Laboratory (Brussels, Belgium) database to enable our analyses. During their two-night stay (including a first night of habituation and a night of polysomnography) at the Sleep Laboratory, these individuals underwent a complete somatic assessment (including blood test, electrocardiogram, daytime electroencephalogram and urinalysis), a systematic psychiatric assessment by a unit psychiatrist and an assessment of their complaints related to sleep. These different steps made it possible to systematically diagnose all somatic pathologies, psychiatric disorders according to the diagnostic criteria of the DSM-IV-TR and sleep pathologies according to the diagnostic criteria of the AASM. This allowed the selection of young adults included in our study based on our inclusion and exclusion criteria. Polysomnographic recordings from our Sleep Laboratory were visually scored according to AASM criteria. An obstructive sleep apnoea-hypopnoea index ≥5/hour was used for the diagnosis of OSAS. At the statistical level, in order to allow our analyses, we subdivided our sample of young adults into two groups: a control group without OSAS (n=215) and a patient group with OSAS (n=49). After checking the normal distribution of our data, normally distributed data were analysed with t-tests whereas asymmetrically or dichotomously distributed data were analysed with Wilcoxon tests or Chi² tests. Univariate regression models were used to study the risk of OSAS associated with major depression (categorized: absent, typical, atypical) in young adults and potential confounding factors. In multivariate regression models, the risk of OSAS associated with major depression (categorized: absent, typical, atypical) in young adults was adjusted only for confounding factors significantly associated with OSAS during univariate analysis. These confounding factors were introduced in a hierarchical manner in the various multivariate regression models constructed.

The prevalence of OSAS in our population of young adults was 18.6 %. During univariate analyses, atypical depression [OR 2.51 (95% CI 1.18–5.32), p-value=0.014], male gender [OR 4.53 (95% CI 2.20–9.34), P-value <0.001], presence of snoring [OR 2.51 (95% CI 1.33–4.75), P-value=0.005], presence of at least one cardio-metabolic alteration [OR 2.26 (95% CI 1.19–4.28), P-value=0.012], body mass index>30 kg/m² [OR 4.55 (95% CI 2.07–10.03), P-value <0.001] and ferritin ≥150 μg/L [OR 3.28 (95% CI 1.69–6.36), P-value<0.001] were associated with increased risk of OSAS in our population of young adults. After adjusting for these major confounding factors associated with OSAS (gender, body mass index, cardio-metabolic alterations, ferritin level, and snoring) in the four models studied, multivariate regression analyses confirmed that unlike typical depression, atypical depression [OR 3.09 (95% CI 1.26–7.54), P-value=0.019] was a risk factor for OSAS in young adults.

In our study, we demonstrated that the prevalence of OSAS was 18.6 % in young adults referred to the Erasme Hospital Sleep Laboratory. In addition, we have shown that unlike typical depression, atypical depression was associated with an increased risk of OSAS in young adults, which seems to justify more systematic research of this pathology in young adults suffering from atypical depression in order to allow the establishment of adapted therapeutic strategies and avoid the negative consequences associated with the co-occurrence of these two pathologies.