title: Risk Factors for Obstructive Sleep Apnea Are Prevalent in People with Psychosis and Correlate with Impaired Social Functioning and Poor Physical Health.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) in the general community is associated with obesity, smoking, alcohol, and sedative medication use and contributes to depressed mood, daytime sedation, and sudden cardiovascular deaths. Poor cardiovascular health, impaired social functioning, and negative and cognitive symptoms are also among the common clinical features of psychotic disorders. People with psychosis have higher rates of sleep disturbance; however, OSA has not been extensively investigated in this population.
  
  
  OBJECTIVE
  This study aimed to determine the prevalence of OSA and general sleep disruption symptoms in a representative Australian sample of people with psychosis. We investigated the prevalence of potential risk factors for OSA, including obesity, psychotropic medications, and substance abuse in this population. Finally, we evaluated associations between symptoms of OSA, symptoms of general sleep disruption, and various clinical features in people with psychosis.
  
  
  METHODS
  Participants took part in the Second National Australian Survey of Psychosis, a population-based survey of Australians with a psychotic disorder aged 18-64 years. Symptoms associated with OSA (snoring and breathing pauses during sleep) in the past year were assessed using questions from the University of Maryland Medical Centre Questionnaire and symptoms associated with general sleep disruption in the past week using the Assessment of Quality of Life Questionnaire. Data collected included psychiatric diagnosis and symptoms, education, employment, medications, smoking status, physical activity, drug and alcohol use, and cognitive function. Physical health measures included body mass index, waist circumference, blood pressure, fasting blood glucose, and lipids.
  
  
  RESULTS
  Snoring was reported by 41.9%; 7% stating they frequently stopped breathing (pauses) during sleep. Univariate logistic regressions show OSA symptoms (pauses and snoring) were associated with older age, female gender, lower levels of social participation or employment, cardiovascular risk factors, sedentary lifestyle, and poorer quality of life, while symptoms of general sleep disruption were more likely in people with depressive symptoms.
  
  
  CONCLUSIONS
  Australians with psychosis have high levels of sleep disturbance, including OSA. OSA symptoms were associated with cardiovascular disease risk factors, reduced social participation and employment, and poorer quality of life. Whether correction of OSA can improve these factors in people with psychosis remains to be determined.
authors.affiliation: Discipline of Psychiatry, School of Medicine, Adelaide University, Adelaide, SA, Australia; Northern Adelaide Local Health Network, Adelaide, SA, Australia.
authors.forename: Dennis
authors.initials: D
authors.lastname: Liu
authors.affiliation: Discipline of Psychiatry, School of Medicine, Adelaide University, Adelaide, SA, Australia; Country Health, Adelaide, SA, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Myles
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Melbourne, VIC , Australia.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Foley
authors.affiliation: Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, School of Medicine and Pharmacology, The University of Western Australia , Perth, WA , Australia.
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Watts
authors.affiliation: Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia , Perth, WA , Australia.
authors.forename: Vera A
authors.initials: VA
authors.lastname: Morgan
authors.affiliation: Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; St. Vincent's Mental Health, Melbourne, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Castle
authors.affiliation: Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia , Perth, WA , Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Waterreus
authors.affiliation: Orygen Youth Health Research Centre, University of Melbourne, Melbourne, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mackinnon
authors.affiliation: Discipline of Psychiatry, School of Medicine, Adelaide University, Adelaide, SA, Australia; Northern Adelaide Local Health Network, Adelaide, SA, Australia; Ramsay Health Care (SA) Mental Health, Adelaide, SA, Australia.
authors.forename: Cherrie Ann
authors.initials: CA
authors.lastname: Galletly
keywords: obstructive sleep apnea; physical health; psychosis; risk factors; social functioning