The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review (original) (raw)
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Obstructive Sleep Apnea and Psychiatry Disorders
2018
The prevalence of Obstructive Sleep Apnea (OSA) has increased remarkably during last twenty years, 60.6% of men and 36.9% of women from 50-70 years old have been diagnosed with OSA, the relevance of this pathology remains in the comorbidities associated with it, one that has not been studied deeply is psychiatric disorders, that have negatively affected the life of patients with OSA. Five main disorders were reviewed according to latest data from 1983 to 2016 on Bipolar Disorder, Dementia, Insomnia, Psychosis, and Attention deficit hyperactivity disorder. For some of this illness the symptomatology is very similar to the ones experienced in OSA, such as sleep deprivation, daytime sleepiness and cognitive impairment and their treatment is difficult due to poor compliance. Recent studies have shown that treatment of OSA with CPAP or surgery has a positive impact in decreasing psychiatric symptoms, four out of the five pathologies reviewed had remarkable improvement of psychiatric symp...
Journal of affective disorders, 2016
Obstructive sleep apnea (OSA) is a health hazard since it is associated with neurocognitive dysfunction and cardio-metabolic diseases. The prevalence of OSA among people with serious mental illness (SMI) is unclear. We searched major electronic databases from inception till 06/2015. Articles were included that reported the prevalence of OSA determined by polysomnography (PSG) or an apnea-hypopnea index (AHI) >5 events/hr, in people with major depressive disorder (MDD), bipolar disorder (BD) or schizophrenia. A random effects meta-analysis calculating the pooled prevalence of OSA and meta-regression of potential moderators were performed. Twelve articles were included representing 570,121 participants with SMI (mean age=38.3 years (SD=7.5)), 45.8% male (range=32-80.4) and mean body mass index (BMI) 25.9 (SD=3.7). The prevalence of OSA in SMI in clinical studies was 25.7% (95% CI 13.9 to 42.4%, n=1,535). Higher frequencies of OSA were seen in MDD (36.3%, 19.4-57.4%, n=525) than in ...
Obstructive Sleep Apnea: An Update for Mental Health Providers
Psychiatric Annals, 2015
Obstructive sleep apnea (OSA) is a common breathing disorder during sleep that has many implications beyond disrupted sleep. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition recognizes three sleep-related breathing disorders-OSA, central sleep apnea, and sleeprelated hypoventilation. OSA has many overlapping symptoms with depression, and is increasingly recognized as an independent risk factor for hypertension and cardiovascular disease. It is crucial for mental health providers to remain vigilant in recognizing patients with signs and symptoms consistent with OSA. This review focuses on updates in terminology and testing, complications of untreated OSA, and its relationship with mental disorders.
Association of psychiatric disorders and sleep apnea in a large cohort
Sleep, 2005
We conducted the present study to determine whether psychiatric disorders are commonly associated with sleep apnea in Veterans Health Administration beneficiaries. The Veterans Health Administration maintains several centralized databases containing healthcare data for more than 4 million veterans. We reviewed data from 1998 to 2001 and identified patient records having International Classification of Diseases-Ninth Edition-Clinical Modification codes indicating sleep apnea and various psychiatric conditions. Subsequently, we compared age, sex, ethnicity, and prevalence of comorbid psychiatric conditions for Veterans Health Administration beneficiaries with and without sleep apnea. Out of 4,060,504 unique cases, 118,105 were identified as having sleep apnea (estimated prevalence of 2.91%). Mean age at the time of diagnosis was 57.6 years. Psychiatric comorbid diagnoses in the sleep apnea group included depression (21.8%), anxiety (16.7%), posttraumatic stress disorder (11.9%), psych...
Psychiatric Symptoms in Sleep Apnea Syndrome
Chest, 1998
Background: Previous studies have suggested an association between Sleep Apnea Syndrome (SAS) and several psychiatric disorders such as depression and anxiety. Study objective: To evaluate the association of SAS with psychiatric symptoms as determined by the SCL-90 psychiatric questionnaire. Methods: The study comprised 2,271 patients (1,977 men, 294 women) referred to the Technion Sleep Laboratories with suspected SAS. They completed the SCL-90 Symptom Self-Report Inventory and then underwent a whole-night polysomnographic examination. The study population was stratified into subgroups according to gender, age, and respiratory disturbance index (RDI). Results: Among men, there were no body mass index, RDI, or age-related differences in anxiety, depression, or in any other SCL-90 dimension. The depression and anxiety scores were significantly higher in women than in men for all age groups and for all levels of RDI. The depression score was higher in women with severe SAS than in women with mild SAS, for all ages. Surprisingly, in women who were only simple snorers, the depression and anxiety scores were higher than in mild SAS sufferers, for all age groups. Conclusions: In our large male population, neither the existence nor the severity of SAS was associated with depression or anxiety. Women had higher anxiety and depression scores, independent of other factors, than men. Women with severe SAS had higher depression scores than women with mild SAS.
Role of psychiatric status assessment of patient with obstructive sleep apnea
Polski Przegląd Otorynolaryngologiczny, 2015
Obstructive sleep apnea (OSA) is a medical problem of a wide social extent. The severe form of the disorder affects 2-4% of population in developed countries while the mild form affects approximately 15% of adults. Predominant symptoms include excessive daytime sleepiness, feeling exhausted, sleep disorders, nightmares, night sweats, and nocturia. It is well known that, over time, untreated severe OSA leads to arterial hypertension, cardiac arrhythmias, impaired myocardial contractility, and acute cardiac events. The knowledge that OSA significantly adversely affects the psychiatric health of the patient is much less common. This literature review examines the available reports on this problem. Psychiatric problems experienced by patients with OSA include excessive daytime sleepiness, insomnia, cognitive disorders, depressive disorders, bipolar disorder, anxiety disorders, posttraumatic stress disorder, psychosis, neurasthenia and other neurotic disorders. About 6.4 to 57.6% of patients with the diagnosis of OSA are reported to suffer from insomnia while the coexistence of both disorders is reported to be associated with a significantly increased risk of acute cardiovascular events. The reason for this is supposedly the increased activity of the hypothalamic-pituitary-adrenal axis due to the arousals resulting in fragmentation of sleep. Other psychiatric disorders are much less common and their incidence does not exceed 10% of cases of obstructive sleep apnea. A considerable variation of data provided by individual investigators should be pointed out, resulting mainly from methodological differences, especially in the criteria for diagnosing insomnia.
Journal of Sleep Disorders : Treatment and Care, 2015
Background-The Berlin and Epworth Sleepiness Scale (ESS) are simple, validated, and widely used questionnaires designed to assess symptoms of obstructive sleep apnea syndrome (OSAS) a common but often unrecognized cause of morbidity and mortality. Methods-A cross-sectional study was conducted among 2,639 college students to examine the extent to which symptoms of OSAS are associated with the odds of common mental disorders (CMDs). The General Health Questionnaire (GHQ-12) was used to evaluate the presence of CMDs while the Berlin and ESS were used to assess high-risk for obstructive sleep apnea (OSA) and excessive daytime sleepiness, respectively. Logistic regression procedures were used to derive odds ratios (OR) and 95% confidence intervals (CI) assessing the independent and joint associations of high-risk for OSA and excessive daytime sleepiness with odds of CMDs. Results-Approximately 19% of students had high-risk for OSA while 26.4% had excessive daytime sleepiness. Compared to students without high-risk for OSA and without excessive daytime sleepiness (referent group), students with excessive daytime sleepiness only (OR=2.01; 95%CI: 1.60-2.52) had increased odds of CMDs. The odds of CMDs for students with high-risk OSA only was 1.26 (OR=1.26; 95%CI 0.94-1.68). Students with both high-risk for OSA and excessive daytime sleepiness, compared to the referent group, had the highest odds of CMDs (OR=2.45; 95%CI: 1.69-3.56). Conclusion-Our findings indicate that symptoms of OSAS are associated with increased risk of CMDs. These findings emphasize the comorbidity of sleep disorders and CMDs and suggest that there may be benefits to investing in educational programs that extend the knowledge of sleep disorders in young adults.
Recognition and Management of Obstructive Sleep Apnea in Psychiatric Practice
The Journal of Clinical Psychiatry, 2023
Objective: The aims of this review were to describe the relationship between obstructive sleep apnea (OSA) and psychiatric disorders and provide an overview of how to recognize/manage OSA in psychiatric practice. Data Sources: A literature search of PubMed was conducted (in adults, English language, no limitation on year). Among others, main keywords included "obstructive sleep apnea" AND "psychiatric. " Study Selection: Articles relevant to the treatment of OSA in psychiatric populations were selected manually. Data Extraction: No formal data charting was conducted. Results: A total of 141 articles were included from the literature search. Comorbid OSA is common among patients with psychiatric disorders, particularly depression and posttraumatic stress disorder. Evidence suggests that OSA may be an independent risk factor for the development of psychiatric conditions, as well as for suicidal ideation and attempts in psychiatric populations. Recognizing OSA in patients with psychiatric disorders can be challenging due to the overlap of symptoms (eg, sleep issues, mood changes, and vegetative symptoms) between OSA, psychiatric disorders, and side effects of psychiatric medications. Inadequately treated OSA can affect the severity of psychiatric symptoms and impair response to psychiatric treatment. Conclusions: Clinicians should not assume that all sleep-related symptoms are consequences of psychiatric illness or medication but should instead be cognizant of the potential for coexisting OSA that requires treatment. Recognizing and managing OSA in patients with psychiatric disorders are critical to improve response to treatment, quality of life, and overall health.
Association Between Obstructive Sleep Apnea and Depression
Background Depression is the leading cause of mental health disorders. Obstructive sleep apnea (OSA) is a common sleep disorder, with a recent increase in prevalence. This study aimed to determine the association between OSA and depressive symptoms. Methods A total of 1,681 men and 2,112 women aged > 40 years from the Korea National Health and Nutrition Examination Survey (2020) were analyzed using multiple logistic regression. OSA was measured using snoring. In addition, apnea and depressive symptoms were measured using the Patient Health Questionnaire-9. Results Individuals with OSA showed a higher likelihood of experiencing depressive symptoms among men (odds ratio [OR]: 1.59, 95% confidence interval [CI]: 1.01–2.48) and women (OR: 2.00, 95% CI: 1.35–2.95). Among men, those who responded to both symptoms of snoring and observed apnea showed a higher likelihood than those who only reported one of the symptoms (OR: 2.10, 95% CI: 1.12–3.92). Women showed more association with tho...
Depression as a manifestation of obstructive sleep apnea
Journal of Neurosciences in Rural Practice, 2017
Background: Obstructive sleep apnea (OSA) often results in a wide range of comorbid conditions, predominantly of the cardiovascular/respiratory, endocrine/metabolic, and neuropsychiatric symptoms. In view of the ambiguity of literature regarding the association between OSA and depression, we conducted this study to show any association between the two disorders. Objective: The aim of the study was to see the association between OSA and depression and to study the prevalence of OSA in patients suffering from depression. Methods: We performed polysomnography (PSG) studies of patients that were referred from various subspecialty clinics from July 2011 to August 2013. Psychiatric diagnosis was done using mini international neuropsychiatric interview plus scale. This was followed by application of Hamilton Depression Rating Scale (HAM-D). Standard methods of statistical analysis were used for data analysis. Results: Out of 182 patients who underwent PSG, 47 were suffering from depression...