[Event-related potential characteristics in adult male patients with obstructive sleep apnea comorbid with depressive state and their correlation with polysomnographic parameters].

Objective: To investigate the characteristics of event-related potential (ERP) in adult males with obstructive sleep apnea (OSA) comorbid with depressive state and their correlation with polysomnography (PSG) parameters. Methods: Cross-sectional study. A total of 77 adult male OSA patients aged 18 to 60 from the Sleep Center of the Second Affiliated Hospital of Soochow University were prospectively enrolled between August 2023 and June 2024. General clinical data, Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), self-rating depression scale (SDS), self-rating anxiety scale (SAS), and PSG parameters were collected. Task-state EEG signals were acquired using a 64-channel system under an emotional facial stimulation paradigm. ERP components were analyzed, including the negative wave occurring at approximately 170 ms (N170) and the positive wave occurring at approximately 300 ms (P300) post-stimulus. Based on the apnea-hypopnea index (AHI) and SDS scores, patients were divided into two groups: the OSA without depressive state group (AHI≥5 events/h and SDS<50) and the OSA with depressive state group (AHI≥5 events/h and SDS≥50). Differences in relevant indicators between the two groups were compared. Spearman correlation analysis was employed to assess the relationships between ERP amplitude/latency and PSG parameters. Results: The 77 OSA patients had a mean age of (40.3±8.1) years. Among them, 51 were classified as the OSA without depressive state group, while 26 comprised the OSA with depressive state group, indicating a depression comorbidity rate of 33.8% in the OSA cohort. The OSA with depressive state group demonstrated significantly higher values compared to the OSA without depressive state group in the following parameters: hypertension comorbidity rate [46.2% (12/26) vs 21.6% (11/51)], ESS score [M (Q1, Q3): 10.0 (5.0, 15.0) vs 7.0 (4.0, 11.0) points], SDS [(55.2±4.4) vs (40.4±6.0) points], and SAS [(43.3±6.0) vs (37.9±7.4) points] (all P<0.05). The OSA with depressive state group exhibited a lower proportion of slow-wave sleep (SWS) compared to the OSA without depressive state group [7.1% (2.9%, 11.4%) vs 13.1% (6.8%, 19.3%), P=0.002], and a higher microarousal index [36.2 (24.9, 45.9) vs 27.9 (16.4, 39.4) events/h, P=0.034]. Furthermore, the N170 latencies at both the PO7 electrode [(261.5±22.4) vs (250.2±23.1) ms] and the PO8 electrode [(261.4±20.2) vs (246.8±23.2) ms] were longer in the OSA with depressive state group (all P<0.05). Correlation analyses revealed a negative correlation between N170 latency at the PO8 electrode and SWS percentage (r=-0.227, P=0.047). Additionally, N170 amplitudes at both the PO7 electrode (r=-0.351, P=0.002) and the PO8 electrode (r=-0.262, P=0.021) showed negative correlations with the microarousal index. Conclusion: Adult male OSA patients with comorbid depression demonstrated prolonged N170 latency in response to emotional facial stimuli, and the alterations in its amplitude and latency were associated with sleep fragmentation.