Hannah Myles1, Nicholas Myles2, Nick A Antic3, Robert Adams4, Madhu Chandratilleke3, Dennis Liu1, Jeremy Mercer3, Andrew Vakulin5, Andrew Vincent6, Gary Wittert6, Cherrie Galletly7. 1. Adelaide University, Adelaide, Australia; Northern Adelaide Local Health Network (NALHN), Australia. 2. The Health Observatory, Discipline of Medicine, TQEH, Australia. 3. Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Australia. 4. Adelaide University, Adelaide, Australia; The Health Observatory, Discipline of Medicine, TQEH, Australia. 5. 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. 6. Adelaide University, Adelaide, Australia; Freemasons Foundation Centre for Men's Health, Australia. 7. Adelaide University, Adelaide, Australia; Northern Adelaide Local Health Network (NALHN), Australia; Ramsay Health Care (SA) Mental Health. Electronic address: cherrie.galletly@adelaide.edu.au.
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. OBJECTIVES: 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. DATA SOURCES: 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. CONCLUSION: 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. Crown
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. OBJECTIVES: 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. DATA SOURCES: 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. CONCLUSION: 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. Crown
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Authors: Hannah Myles; Nicholas Myles; Ching Li Chai Coetzer; Robert Adams; Madhu Chandratilleke; Dennis Liu; Jeremy Mercer; Andrew Vakulin; Andrew Vincent; Gary Wittert; Cherrie Galletly Journal: Schizophr Res Cogn Date: 2018-11-06