Schizophrenia, obesity, and obstructive sleep apnea

Background: This study evaluated the risk factors for obstructive sleep apn ea in psychiatric patients. Method: The subjects were 364 patients referred to a sleep disorders consul tation service from an inpatient psychiatric hospital. Seventy-eight percen t underwent polysomnographic testing. Rates of obstructive sleep apnea in d ifferent diagnostic groups (established by clinical DSM-III-R diagnosis) we re retrospectively assessed. Results: Logistic regression demonstrated significant independent effects o f age (p = .046), gender (p = .002), body mass index (p < .001), and chroni c neuroleptic use (p = .012) on the presence of obstructive sleep apnea (de fined as more than 20 instances of apnea and/or hypopnea per hour of sleep) . Patients with schizophrenia were significantly heavier and had higher rat es of sleep apnea than did other psychiatric patients. Conclusion: Obesity, male gender, and chronic neuroleptic administration ar e risk factors for obstructive sleep apnea in psychiatric patients. Since p atients with schizophrenia are often on long-term neuroleptic treatment, th ey may have high rates of obstructive sleep apnea, mediated via the weight gain produced by such medications. Overweight psychiatric patients and thos e on chronic neuroleptic treatment (e.g., patients with schizophrenia) shou ld be evaluated for sleep apnea if signs and symptoms of this disorder are present.