title: High rates of obstructive sleep apnea symptoms among patients with schizophrenia.
abstract: BACKGROUND
  Patients with schizophrenia have high rates of obesity and cardiovascular morbidity, which are strongly associated with obstructive sleep apnea (OSA). The prevalence and risk factors for OSA are not well studied in patients with schizophrenia.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the frequency of OSA symptoms in a sample of outpatients with schizophrenia.
  
  
  METHODS
  This cross-sectional study was a secondary analysis of data generated from an insomnia study that evaluated 175 outpatients with schizophrenia or schizoaffective disorder in a single, large urban community mental health center. Results of scales evaluating insomnia were used to complete the STOP questionnaire, which is a screening tool for OSA validated in surgical populations. Appropriate statistical analysis was done to compare participants across groups.
  
  
  RESULTS
  Patients were classified into high risk for OSA (STOP ≥ 2) (57.7%), and low risk for OSA (STOP score < 2) (42.3%). We also identified patients with a known diagnosis of OSA (14.9%). Patients with diagnosed OSA had significantly higher STOP scores (mean 2.7 vs. 1.6 [t = 6.3; p < 0.001]). Only 23.8% of patients in the high-risk group were diagnosed with OSA. Body mass index was significantly higher in the diagnosed group (F[2,169] = 25; p < 0.001) as was diabetes (χ2 [2, N = 175] = 35, p < 0.001).
  
  
  CONCLUSIONS
  A large number of outpatients with severe mental illness are at high risk for OSA. The STOP questionnaire is easy to use and appears to have a very high clinical utility to detect OSA. Based on our findings, further studies are warranted to validate the tool in patients with severe mental illness.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT (AA, LBP, VHS, CT). Electronic address: Aniyizhai.annamalai@yale.edu.
authors.forename: Aniyizhai
authors.initials: A
authors.lastname: Annamalai
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT (AA, LBP, VHS, CT).
authors.forename: Laura B
authors.initials: LB
authors.lastname: Palmese
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA (LAC).
authors.forename: Lydia A
authors.initials: LA
authors.lastname: Chwastiak
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT (AA, LBP, VHS, CT).
authors.forename: Vinod H
authors.initials: VH
authors.lastname: Srihari
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT (AA, LBP, VHS, CT).
authors.forename: Cenk
authors.initials: C
authors.lastname: Tek
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology*; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D011795:Surveys and Questionnaires