A weight-independent association between atypical antipsychotic medications and obstructive sleep apnea

Khazaie, Habibolah; Sharafkhaneh, Amir; Khazaie, Sepideh; Ghadami, Mohammad Rasoul

doi:10.1007/s11325-017-1537-y

Cited by 14 publications

(15 citation statements)

References 30 publications

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“…This result agrees with results obtained from previous studies about effects of AAs on OSA [7,[13][14][15][16]. For instance, Khazaie et al [17] and Rishi et al [18] have compared the severity of OSA in patients taking AAs to that in the control group. After matching the two groups in terms of age, gender, BMI, and NC, it was found that the risk of OSA was significantly higher in patients with schizophrenia using AAs.…”

Section: Smrsupporting

confidence: 91%

Effect of Atypical Antipsychotic Medications on the Risk of Obstructive Sleep Apnea in Individuals With Schizophrenia

et al. 2022

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Background and Objective Weight gain and obesity could be side effects of taking atypical antipsychotic medications. They are major risk factors for obstructive sleep apnea. The purpose of this study was to investigate effects of atypical antipsychotic medications on the risk of obstructive sleep apnea in individuals with schizophrenia and control groups.Methods In this cross-sectional study, 123 patients with schizophrenia and 107 participants were selected from hospital staff and students using purposive sampling. Data were collected using structured clinical interview and Berlin questionnaires.Results Results showed that the risk of obstructive sleep apnea was significantly higher in individuals with schizophrenia. Age, body mass index, and phases of schizophrenia showed meaningful relationships with the duration of taking atypical antipsychotic medications with the risk of obstructive sleep apnea. However, the type of atypical antipsychotic medications did not have a significant relationship with the risk of obstructive sleep apnea.Conclusions Patients with schizophrenia treated with atypical antipsychotic medicationshave a higher risk of obstructive sleep apnea.

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Section: Smrsupporting

confidence: 91%

Effect of Atypical Antipsychotic Medications on the Risk of Obstructive Sleep Apnea in Individuals With Schizophrenia

et al. 2022

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“…Although previous definitions of unexpected death in children and youths have excluded unintentional drug overdoses, 56 we included these deaths because the clinical circumstances often are similar to those of deaths due to cardiovascular causes (eg, unexplained death during sleep), and it can be difficult to distinguish the mechanisms post mortem. 61,62 Furthermore, antipsychotics are potent central nervous system depressants 54,55 that can impair respiration [25][26][27][28][29][30] and thus could increase risk of fatal inadvertent overdose with other medications. Our analysis that did not consider overdoses as unexpected deaths showed increased risk of comparable magnitude to that of the primary analysis.…”

Section: Discussionmentioning

confidence: 99%

Association of Antipsychotic Treatment With Risk of Unexpected Death Among Children and Youths

et al. 2019

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IMPORTANCE Children and youths who are prescribed antipsychotic medications have multiple, potentially fatal, dose-related cardiovascular, metabolic, and other adverse events, but whether or not these medications are associated with an increased risk of death is unknown.OBJECTIVE To compare the risk of unexpected death among children and youths who are beginning treatment with antipsychotic or control medications. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study was conducted from 1999 through 2014 and included Medicaid enrollees aged 5 to 24 years in Tennessee who had no diagnosis of severe somatic illness, schizophrenia or related psychoses, or Tourette syndrome or chronic tic disorder. Data analysis was performed from January 1, 2017, to August 15, 2018.EXPOSURES Current, new antipsychotic medication use at doses higher than 50 mg (higher-dose group) or 50 mg or lower chlorpromazine equivalents (lower-dose group) as well as control medications (ie, attention-deficit/hyperactivity disorder medications, antidepressants, or mood stabilizers) (control group). MAIN OUTCOMES AND MEASURESDeaths during study follow-up while out of hospital or within 7 days after hospital admission, classified as either deaths due to injury or suicide or unexpected deaths. Secondary outcomes were unexpected deaths not due to overdose and death due to cardiovascular or metabolic causes. RESULTSThis study included 189 361 children and youths in the control group (mean [SD] age, 12.0 [5.1] years; 43.4% female), 28 377 in the lower-dose group (mean [SD] age, 11.7 [4.4] years; 32.3% female), and 30 120 in the higher-dose group (mean [SD] age, 14.5 [4.8] years; 39.2% female). The unadjusted incidence of death in the higher-dose group was 146.2 per 100 000 person-years (40 deaths per 27 354 person-years), which was significantly greater than that in the control group (54.5 per 100 000 population; 67 deaths per 123 005 person-years) (P < .001). The difference was primarily attributable to the increased incidence of unexpected deaths in the higher-dose group (21 deaths; 76.8 per 100 000 population) compared with the control group (22 deaths; 17.9 per 100 000 population). The propensity score-adjusted hazard ratios were as follows: all deaths (1.80; 95% CI, 1.06-3.07), deaths due to unintentional injury or suicide (1.03; 95% CI, 0.53-2.01), and unexpected deaths (3.51; 95% CI, 1.54-7.96). The hazard ratio was 3.50 (95% CI, 1.35-9.11) for unexpected deaths not due to overdose and 4.29 (95% CI, 1.33-13.89) for deaths due to cardiovascular or metabolic causes. Neither the unadjusted nor adjusted incidence of death in the lower-dose group differed significantly from that in the control group. CONCLUSIONS AND RELEVANCEThe findings suggest that antipsychotic use is associated with increased risk of unexpected death and appear to reinforce recommendations for careful prescribing and monitoring of antipsychotic treatment for children and youths and to underscore the need for larger antipsychotic treatment safety studies in this population.

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“…Any condition that disrupts sleep could affect the restorative ability of this state. OSA is one of the more prevalent sleep conditions that leads to sleep fragmentation and hypoxia due to the repetitive occurrence of apnea or hypopnea during sleep …”

Section: Discussionmentioning

confidence: 99%

Serum testosterone/cortisol ratio in people with obstructive sleep apnea

Mohammadi

Rezaei

Sharafkhaneh

et al. 2019

Clinical Laboratory Analysis

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Objectives Obstructive sleep apnea (OSA) is a major health problem that has been associated with endocrine dysfunction in the hypothalamic‐pituitary‐gonadal (HPG) and hypothalamic‐pituitary‐adrenal (HPA) axes. This study investigated cortisol, testosterone, and the testosterone/cortisol ratio in patients with OSA compared to normal sleepers. Methods Thirty‐nine OSA patients diagnosed by overnight polysomnography (PSG) were divided into three groups, including ten mild OSA patients, 16 patients with moderate OSA, and 13 patients with severe OSA according to the apnea‐hypopnea index (AHI). In addition, 13 normal sleepers with normal PSG findings were recruited as the control group. Serum levels of cortisol, testosterone, and sex hormone‐binding globulin (SHBG) were measured using enzyme‐linked immunosorbent assay (ELISA). Results There were no significant differences between the normal sleepers and the three subtypes of OSA in terms of total and free testosterone levels (P > .1). The results showed significantly higher levels of cortisol in the severe OSA group compared to the normal sleepers and the two other subtypes of OSA (P < .01). In addition, the testosterone/cortisol (T/C) ratio was significantly lower among the severe OSA compared to the moderate OSA patients (P = .01). A significant correlation was observed between minimal SpO2 and AHI (r=−0.69, P < .01), cortisol and AHI (r = .47, P < .01) and cortisol and minimal SpO2 (r = −.26, P = .06). Conclusion According to the findings, OSA is linked to HPA axis activity in severe OSA patients but not among the mild and moderate subtypes of the disorder.

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A weight-independent association between atypical antipsychotic medications and obstructive sleep apnea

Abstract: While AAP medications are known cause of weight gain as a main risk factor of OSA, our finding demonstrated a weight-independent association between AAP medications and worsening respiration during sleep.

Cited by 14 publications

References 30 publications

Effect of Atypical Antipsychotic Medications on the Risk of Obstructive Sleep Apnea in Individuals With Schizophrenia

Effect of Atypical Antipsychotic Medications on the Risk of Obstructive Sleep Apnea in Individuals With Schizophrenia

Association of Antipsychotic Treatment With Risk of Unexpected Death Among Children and Youths

Serum testosterone/cortisol ratio in people with obstructive sleep apnea

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