Schizophrenia, obesity, and obstructive sleep apnea.
BACKGROUND
This study evaluated the risk factors for obstructive sleep apnea in psychiatric patients.


METHODS
The subjects were 364 patients referred to a sleep disorders consultation service from an inpatient psychiatric hospital. Seventy-eight percent underwent polysomnographic testing. Rates of obstructive sleep apnea in different diagnostic groups (established by clinical DSM-III-R diagnosis) were retrospectively assessed.


RESULTS
Logistic regression demonstrated significant independent effects of age (p = .046), gender (p = .002), body mass index (p < .001), and chronic neuroleptic use (p = .012) on the presence of obstructive sleep apnea (defined as more than 20 instances of apnea and/or hypopnea per hour of sleep). Patients with schizophrenia were significantly heavier and had higher rates of sleep apnea than did other psychiatric patients.


CONCLUSIONS
Obesity, male gender, and chronic neuroleptic administration are risk factors for obstructive sleep apnea in psychiatric patients. Since patients with schizophrenia are often on long-term neuroleptic treatment, they may have high rates of obstructive sleep apnea, mediated via the weight gain produced by such medications. Overweight psychiatric patients and those on chronic neuroleptic treatment (e.g., patients with schizophrenia) should be evaluated for sleep apnea if signs and symptoms of this disorder are present.
Sleep Disorders Program, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02459, USA. jwinkelman@sleephealth.com
J W
JW
Winkelman
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D009765:Obesity / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D017286:Polysomnography / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents