Sleep-disordered breathing and periodic limb movements in sleep in older patients with schizophrenia

Ancoli‐Israel, Sonia; Martin, Jennifer L.; Jones, D. R.; Caligiuri, Michael P.; Patterson, Thomas L.; Harris, M. Jackuelyn; Jeste, Dilip V.

doi:10.1016/s0006-3223(98)00166-8

Cited by 70 publications

(46 citation statements)

References 31 publications

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“…In contrast an older population (mean age 59 years) studied by Ancoli-Israel 6 showed that 48% of the population had an AHI of > 10 events per hour. The most recent study to look at sleep apnoea in psychiatric outpatients showed that 9.7% of their population reported a diagnosis of sleep apnoea although sleep studies were not performed 7 .…”

Section: Discussionmentioning

confidence: 87%

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Sleep disordered breathing in community psychiatric patients

et al. 2012

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-Background and Objectives:Sleep disturbance is prominent in many neuropsychiatric disorders and may precipitate or exacerbate a range of psychiatric conditions. Few studies have investigated sleep disordered breathing and in particular obstructive sleep apnoea in community psychiatric patients and the commonly used screening instruments have not been evaluated in patients with psychiatric disorders. The objective is to evaluate the prevalence of sleep disordered breathing in a community cohort with chronic mental illness on long term psychotropic medication, and to assess the effectiveness of commonly used screening instruments to detect abnormal sleep.Methods: 52 patients completed sleep questionnaires and 50 undertook overnight oximetry. Results: 52% (n = 26) had sleep-disordered breathing; 20% (n = 10) had moderate/severe sleep apnoea. The Epworth Sleepiness Score and the Pittsburgh Sleep Quality Inventory did not predict sleep disordered breathing.Conclusions: Patients with psychiatric disorders in the community have a high rate of undiagnosed sleep disordered breathing, which is not reliably detected by established sleep disorder screening questionnaires.

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Section: Discussionmentioning

confidence: 87%

“…Sleep disturbance in psychiatric populations may be due to the psychiatric illness, psychotropic medication or the result of a primary sleep disorder. The prevalence of sleep apnoea in the psychiatric population in the community has been studied with conflicting results [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Sleep disordered breathing in community psychiatric patients

et al. 2012

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“…25,31 The clinic-based population showed a 48% prevalence of OSA in mixed schizophrenia and schizoaffective disorder participants. 31 The population-based study conducted using the United States Veterans Health Administration (VHA) records reported an OSA prevalence in pooled schizophrenia and psychotic disorders of 4.52%. 25 …”

Section: Schizophrenia and Psychotic Disordersmentioning

confidence: 99%

Obstructive Sleep Apnea and Psychiatric Disorders: A Systematic Review

Gupta

Simpson

2015

Journal of Clinical Sleep Medicine

260

156

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Study Objectives: Obstructive sleep apnea (OSA) has been associated with psychiatric pathology. Psychiatric comorbidity in OSA may affect patient quality of life and adherence to CPAP. A focused evaluation of OSA in highly selected groups of primarily psychiatric patients may provide further insights into the factors contributing to comorbidity of OSA and psychopathology. The goal of this study is to examine the prevalence and treatment of OSA in psychiatric populations. Methods: A systematic review following the PRISMA guidelines was conducted to determine the prevalence of OSA in schizophrenia and other psychotic disorders, mood disorders, and anxiety disorders, and to examine potential interventions. The PubMed, EMBASE, and PsycINFO databases were searched (last search April 26, 2014) using keywords based on the ICD-9-CM coding for OSA and the DSM-IV-TR diagnostic groups. Results: The search retrieved 48 records concerning studies of OSA in the selected disorders. The prevalence studies indicate that there may be an increased prevalence of OSA in individuals with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), despite considerable heterogeneity and a high risk of bias. There was insuffi cient evidence to support increased OSA in schizophrenia and psychotic disorders, bipolar and related disorders, and anxiety disorders other than PTSD. Studies of treatment of OSA indicate an improvement in both OSA and psychiatric symptoms. CPAP adherence was reduced in veterans with PTSD. Conclusions: OSA prevalence may be increased in MDD and PTSD. In individuals with OSA and psychiatric illness, treatment of both disorders should be considered for optimal treatment outcomes. 1 According to a major US study of OSA diagnosed by polysomnography (PSG), the prevalence of OSA, as defi ned by an apnea-hypopnea index (AHI) ≥ 5 and without inclusion of a daytime sleepiness criterion, was reported as 24% for men and 9% for women under the age of 65 years; addition of a daytime sleepiness criterion reduced these estimates to 4% for men and 2% for women. 1,2 OSA is commonly associated with metabolic syndrome including comorbid obesity, hypertension, and diabetes.1 Upper airway obstruction may present as apneas, hypopneas, or respiratory effort-related arousals (RERAs), resulting in oxygen desaturation, repeated arousals and sleep fragmentation. Recently, there has been an increase in reports of comorbidity of OSA with psychological/psychiatric symptoms. Psychiatric comorbidity in OSA has been reported to adversely affect the quality of life of OSA patients and adherence to CPAP therapy. 3-5Psychological symptoms such as depression and anxiety are commonly reported in adults with OSA; however, the relationship between OSA and full psychiatric syndromes is less clear. Global prevalence studies and reviews have suggested that there are elevated rates of psychological symptoms in individuals with OSA. [17][18][19] Studies that have evaluated the prevalence of OSA in the highly selected groups of psychiatric popu...

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Section: Obstructive Sleep Apnoeamentioning

confidence: 99%

“…Several studies of OSA in SZ exist [23,24], which point to significantly elevated rates of OSA in these populations. Estimates range between 25% reported by Waters et al [25] in an audit of SZ inpatients using self-reports, and 48% reported by Ancoli-Israel et al (1999) [24] using a portable sleep recording device in 52 older patients with schizophrenia (mean age of 59.6 years). In an examination of the Veterans Health Admini-stration database, Sharafkhaneh et al [26] found that a diagnosis of psychosis (including schizophrenia and schizo-affective disorders) increased the odds ratio of having sleep apnoea by 1.35, which was independent of substance abuse, age or sex.…”

Section: Obstructive Sleep Apnoeamentioning

confidence: 99%