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  1. Article ; Online: Gender differences in obstructive sleep apnea with comorbid treatment-resistant depression

    Emily Kasurak / Emily Hawken / Dusan Kolar / Ruzica Jokic

    Sleep Science and Practice, Vol 7, Iss 1, Pp 1-

    2023  Volume 9

    Abstract: Abstract Background A bidirectional relationship between major depression and obstructive sleep apnea (OSA) has been established, suggesting the possibility of overlapping and compounding disease processes. Depression, however, while more prevalent in ... ...

    Abstract Abstract Background A bidirectional relationship between major depression and obstructive sleep apnea (OSA) has been established, suggesting the possibility of overlapping and compounding disease processes. Depression, however, while more prevalent in women, is a highly heterogeneous disorder and can be difficult to treat regardless of gender. A common overlapping symptom of depression and OSA is fatigue. Gender differences in OSA symptomatology (and fatigue in particular) are also consistently observed. Here, we investigate OSA in specific relation to treatment-resistant depression. Methods A cross-sectional exploratory design was used to analyse data from 94 patients with treatment-resistant depression from a subspecialist mood disorders outpatient service who had no previous sleep assessment. Participants completed overnight polysomnography and a battery of rating scales assessing mood, sleep, and daytime functioning. Linear regression models determined whether presence of fatigue in treatment-resistant depression predicted OSA severity. Results There was a high prevalence (79%) of previously undiagnosed OSA in our sample of patients with treatment-resistant depression. Treatment-resistant depression was one factor to close the gap in obstructive sleep apnea prevalence between men and women in this group. Presence of OSA measured objectively by the Apnea Hypopnea Index was not associated with episode state (depressed vs. euthymic). Daytime sleepiness scores as measured by the Epworth Sleepiness Scale indicated higher than normal daytime sleepiness with no difference between genders. Men and women in our study reported similar amounts of fatigue as measured by the Profile of Mood States-Fatigue Subscale, however, daytime fatigue (but not sleepiness) predicted OSA severity in women only. Conclusions We argue that typical symptoms of treatment-resistant depression may overshadow key symptoms of undetected OSA. Specifically, we found that daytime fatigue may be one factor masking a potentially significant ...
    Keywords Obstructive sleep apnea ; Treatment-resistant depression ; Sleep disordered breathing ; Gender differences ; Fatigue ; Medicine ; R
    Subject code 150
    Language English
    Publishing date 2023-06-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Association of intranasal esketamine, a novel ‘standard of care’ treatment and outcomes in the management of patients with treatment-resistant depression

    Peter Giacobbe / Ayal Schaffer / Raymond W Lam / Roumen Milev / Gustavo Vazquez / Gilmar Gutierrez / Joshua Rosenblat / Jennifer Swainson / Ganapathy Karthikeyan / Nisha Ravindran / André Do / Emily Hawken

    BMJ Open, Vol 12, Iss

    protocol of a prospective cohort observational study of naturalistic clinical practice

    2022  Volume 9

    Abstract: Introduction Esketamine is the S-enantiomer of racemic ketamine and has been approved by the Food and Drug Administration for the management of treatment resistant depression, demonstrating effective and long-lasting benefits. The objective of this ... ...

    Abstract Introduction Esketamine is the S-enantiomer of racemic ketamine and has been approved by the Food and Drug Administration for the management of treatment resistant depression, demonstrating effective and long-lasting benefits. The objective of this observational study is to elucidate the association of intranasal (IN) esketamine with beneficial and negative outcomes in the management of treatment resistant major depressive disorder.Methods and analysis This is a multicentre prospective cohort observational study of naturalistic clinical practice. We expect to recruit 10 patients per research centre (6 centres, total 60 subjects). After approval to receive IN esketamine as part of their standard of care management of moderate to severe treatment resistant depression, patients will be invited to participate in this study. Association of esketamine treatment with outcomes in the management of depression will be assessed by measuring the severity of depression symptoms using the Montgomery-Åsberg Depression Rating Scale (MADRS), and tolerability by systematically tracking common side effects of ketamine treatment, dissociation using the simplified 6-Item Clinician Administered Dissociative Symptom Scale and potential for abuse using the Likeability and Craving Questionnaire (LCQ). Change in depressive symptoms (MADRS total scores) over time will be evaluated by within-subject repeated measures analysis of variance. We will calculate the relative risk associated with the beneficial (reduction in total scores for depression) outcomes, and the side effect and dropout rates (tolerability) of adding IN esketamine to patients’ current pharmacological treatments. Covariate analysis will assess the impact of site and demographic variables on treatment outcomes.Ethics and dissemination Approval to perform this study was obtained through the Health Sciences Research Ethics Board at Queen’s University. Findings will be shared among collaborators, through departmental meetings, presented on different academic venues and ...
    Keywords Medicine ; R
    Subject code 310
    Language English
    Publishing date 2022-09-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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