Association of psychiatric disorders and sleep apnea in a large cohort.
OBJECTIVE
We conducted the present study to determine whether psychiatric disorders are commonly associated with sleep apnea in Veterans Health Administration beneficiaries.


METHODS
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.


RESULTS
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%), psychosis (5.1), and bipolar disorders (3.3%). Compared with patients not diagnosed with sleep apnea, a significantly greater prevalence (P < .0001) was found for mood disorders, anxiety, posttraumatic stress disorder, psychosis, and dementia in patients with sleep apnea.


CONCLUSIONS
Sleep apnea is associated with a higher prevalence of psychiatric comorbid conditions in Veterans Health Administration beneficiaries. This association suggests that patients with psychiatric disorders and coincident symptoms suggesting sleep-disordered breathing should be evaluated for sleep apnea.
Sharafkhaneh
Amir
A
Department of Medicine at Baylor College of Medicine, VAMC Sleep Center, Houston, TX 77030, USA. amirs@bcm.tmc.edu
Giray
Nilgun
N
Richardson
Peter
P
Young
Terry
T
Hirshkowitz
Max
M
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D012892:Sleep Deprivation / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D014728:Veterans / Q000706:statistics & numerical data