title: Obstructive sleep apnea and schizophrenia: A systematic review to inform clinical practice.
abstract: BACKGROUND
  Risk factors for obstructive sleep apnea (OSA) are common in people with schizophrenia. Identification and treatment of OSA may improve physical health in this population; however there are no guidelines to inform screening and management.
  
  
  OBJECTIVE
  Systematic review to determine, in people with schizophrenia and related disorders: the prevalence of OSA; the prevalence of OSA compared to general population controls; the physical and psychiatric correlates of OSA, associations between antipsychotic medications and OSA; the impact of treatment of OSA on psychiatric and physical health; and the diagnostic validity of OSA screening tools.
  
  
  METHODS
  Medline, EMBASE, ISI Web of Science and PsycINFO electronic databases. Cohort, case-control and cross-sectional studies and RCTs reporting on prevalence of OSA in subjects with schizophrenia and related disorders were reviewed.
  
  
  RESULTS
  The prevalence of OSA varied between 1.6% and 52%. The prevalence of OSA was similar between people with schizophrenia and population controls in two studies. Diagnosis of OSA was associated with larger neck circumference, BMI>25, male sex and age>50years. There were no data on physical or psychiatric outcomes following treatment of OSA. The diagnostic utility of OSA screening tools had not been investigated.
  
  
  CONCLUSIONS
  OSA may be prevalent and potentially under-recognized in people with schizophrenia. Further research is required to determine utility of OSA screening tools, the relationships between antipsychotic medications and OSA and any benefits of treating OSA. We propose a strategy for the identification of OSA in people with schizophrenia and related disorders.
authors.affiliation: Adelaide University, Adelaide, Australia; Northern Adelaide Local Health Network (NALHN), Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Myles
authors.affiliation: The Health Observatory, Discipline of Medicine, TQEH, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Myles
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia.
authors.forename: Nick A
authors.initials: NA
authors.lastname: Antic
authors.affiliation: Adelaide University, Adelaide, Australia; The Health Observatory, Discipline of Medicine, TQEH, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Adams
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia.
authors.forename: Madhu
authors.initials: M
authors.lastname: Chandratilleke
authors.affiliation: Adelaide University, Adelaide, Australia; Northern Adelaide Local Health Network (NALHN), Australia.
authors.forename: Dennis
authors.initials: D
authors.lastname: Liu
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Mercer
authors.affiliation: Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia; NeuroSleep and Woolcock Institute of Medical Research, University of Sydney, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Vakulin
authors.affiliation: Adelaide University, Adelaide, Australia; Freemasons Foundation Centre for Men's Health, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Vincent
authors.affiliation: Adelaide University, Adelaide, Australia; Freemasons Foundation Centre for Men's Health, Australia.
authors.forename: Gary
authors.initials: G
authors.lastname: Wittert
authors.affiliation: Adelaide University, Adelaide, Australia; Northern Adelaide Local Health Network (NALHN), Australia; Ramsay Health Care (SA) Mental Health. Electronic address: cherrie.galletly@adelaide.edu.au.
authors.forename: Cherrie
authors.initials: C
authors.lastname: Galletly
mesh_terms: D006801:Humans; D012559:Schizophrenia / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*
keywords: Obstructive sleep apnea; Psychosis; Schizophrenia; systematic review