scholarly journals The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kaja Hanna Karakuła ◽  
Aleksander Ryczkowski ◽  
Elżbieta Sitarz ◽  
Jacek Januszewski ◽  
Dariusz Juchnowicz
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Sleep Apnea ◽  
Mental Disorders ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
List Type ◽  
Study Protocols ◽  
Obstructive Sleep ◽  
Increased Risk

Abstract Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Its prevalence tends to increase worldwide. Untreated sleep apnea is associated with a higher risk of metabolic diseases, cardiovascular diseases, stroke, road accidents, and death, but also it is suggested that it increases the risk of mental disorders. Method: The literature review was based on a search of articles on Medline, Pubmed, and Google Scholar from 2003 to 2021 using the keywords: obstructive sleep apnea; mental disorders; cognitive functions; affective disorders; depression; bipolar disorder; schizophrenia; psychotic disorders. The analysis included original studies, meta-analysis, and review articles. Discussion: The result obtained from researches published so far does not allow for drawing unequivocal conclusions. There is a lot of bias present in study protocols and inclusion/exclusion criteria. Nonetheless, it seems that some disorders have a better proven correlation with OSA. Cognitive impairment, depression, and anxiety disorders are linked to OSA not only in terms of the overlapping of symptoms but also of a causal relationship. Psychotic disorders and bipolar disorders connections with OSA are confirmed, but they are not yet well understood. All correlations are found to be possibly bidirectional. Conclusion: 1. Multiple lines of evidence increasingly point towards a bidirectional connection between OSA and mental disorders, and the cause and effect relationship between these two groups of disorders requires further research. 2. Due to reports of an increased risk of OSA with antipsychotic drugs, caution should be exercised when initiating therapy with this type of drug in patients with known risk factors for it. 3. Screening for OSA in psychiatric patients should be introduced as OSA can increase cognitive impairment, affective, and psychotic symptoms.

scholarly journals Modafinil in the treatment of selected mental disorders

2021 ◽  
Vol 21 (3) ◽  
pp. 204-212
Author(s):  
Wacław Dyrda ◽  
Daria Smułek ◽  
Adam Wichniak ◽  
Keyword(s):  
Cognitive Impairment ◽  
Mental Disorders ◽  
Negative Symptoms ◽  
Depressive Disorders ◽  
Bipolar Depression ◽  
Sleep Apnoea ◽  
Psychotic Symptoms ◽  
Manic Symptoms ◽  
Obstructive Sleep ◽  
Increased Risk

Modafinil belongs to a class of wakefulness promoting agents. It is widely used in the treatment of sleep disorders. Although narcolepsy is the main indication for its use, hypersomnia from obstructive sleep apnoea and shift work sleep disorder are also indications in some countries. Due to its efficacy in the treatment of hypersomnia, the drug has also been clinically assessed in patients with mental disorders to reduce the severity of symptoms such as fatigue, hypersomnolence and cognitive impairment. The aim of this paper is to present the potential clinical applications of modafinil in the treatment of selected mental disorders. The use of modafinil in depressive disorders to enhance the treatment applied may improve mood, anhedonia and apathy, fatigue, hypersomnolence and executive cognitive impairment. In severe episodes of bipolar depression, modafinil may improve depressive symptoms, fatigue, and hypersomnia. Despite the potential risk of manic symptoms during modafinil treatment, recent studies show no increased risk of switching from depressive to manic phase. In schizophrenia, there is no evidence for the beneficial effect of modafinil on the negative symptoms, but improvement in selected cognitive functions accompanied by exacerbation of psychotic symptoms was observed in some patients. Furthermore, modafinil is used as an alternative to standard therapy in attention-deficit/hyperactivity disorder. Despite lacking evidence for the efficacy of modafinil in cocaine addiction, an analysis of selected studies indicates a potential benefit in the form of maintained abstinence. Modafinil is well tolerated and safe in most cases. The risk of dependence is lower than with other psychostimulants.

827 Central Sleep Apnea in a patient with Multiple Sclerosis

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A322-A323
Author(s):  
Rahul Dasgupta ◽  
Sonja Schütz ◽  
Tiffany Braley
Keyword(s):  
Multiple Sclerosis ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Central Sleep Apnea ◽  
Progressive Multiple Sclerosis ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Demyelinating Lesions ◽  
The Brain

Abstract Introduction Sleep-disordered breathing is common in persons with multiple sclerosis (PwMS), and may contribute to debilitating fatigue and other chronic MS symptoms. The majority of research to date on SDB in MS has focused on the prevalence and consequences of obstructive sleep apnea; however, PwMS may also be at increased risk for central sleep apnea (CSA), and the utility of methods to assess CSA in PwMS warrant further exploration. We present a patient with secondary progressive multiple sclerosis who was found to have severe central sleep apnea on WatchPAT testing. Report of case(s) A 61 year-old female with a past medical history of secondary progressive multiple sclerosis presented with complaints of fragmented sleep. MRI of the brain, cervical spine, and thoracic spine showed numerous demyelinating lesions in the brain, brainstem, cervical, and thoracic spinal cord. Upon presentation, the patient noted snoring, witnessed apneas, and daytime sleepiness. WatchPAT demonstrated severe sleep apnea, with a pAHI of 63.3, and a minimum oxygen saturation of 90%. The majority of the scored events were non-obstructive in nature (73.1% of all scored events), and occurred intermittently in a periodic fashion. Conclusion The differential diagnosis of fatigue in PwMS should include sleep-disordered breathing, including both obstructive and central forms of sleep apnea. Demyelinating lesions in the brainstem (which may contribute to impairment of motor and sensory networks that control airway patency and respiratory drive), and progressive forms of MS, have been linked to both OSA and CSA. The present data illustrate this relationship in a person with progressive MS, and offer support for the WatchPAT as a cost-effective means to evaluate for both OSA and CSA in PwMS, while reducing patient burden. PwMS may be at increased risk for CSA. Careful clinical consideration should be given to ordering appropriate sleep testing to differentiate central from obstructive sleep apnea in PwMS, particularly for patients with demyelinating lesions in the brainstem. Support (if any) 1. Braley TJ, Segal BM, Chervin RD. Obstructive sleep apnea and fatigue in patients with multiple sclerosis. J Clin Sleep Med. 2014 Feb 15;10(2):155–62. doi: 10.5664/jcsm.3442. PMID: 24532998; PMCID: PMC3899317.

Obstructive Sleep Apnea in a 17-Year-Old With Profound Cognitive Impairment

PEDIATRICS ◽  
2013 ◽  
Vol 131 (3) ◽  
pp. 581-585
Author(s):  
D. Rosen ◽  
B. Wilfond ◽  
J. D. Lantos
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Sleep Apnea ◽  
Obstructive Sleep

scholarly journals Increased Risk of Parkinsonʼs Disease in Patients With Obstructive Sleep Apnea

Medicine ◽  
2016 ◽  
Vol 95 (2) ◽  
pp. e2293 ◽  
Author(s):  
Nai-Cheng Yeh ◽  
Kai-Jen Tien ◽  
Chun-Ming Yang ◽  
Jhi-Joung Wang ◽  
Shih-Feng Weng
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep ◽  
Increased Risk

scholarly journals Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 368
Author(s):  
Leeba Rezaie ◽  
Soroush Maazinezhad ◽  
Donald J. Fogelberg ◽  
Habibolah Khazaie ◽  
Dena Sadeghi-Bahmani ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Multiple Regression ◽  
Daytime Sleepiness ◽  
Respiratory Disturbance Index ◽  
Disturbance Index ◽  
Related Data ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Respiratory Disturbance

Objective: Individuals with obstructive sleep apnea (OSA) are at increased risk to suffer from further somatic and sleep-related complaints. To assess OSA, demographic, anthropometric, and subjective/objective sleep parameters are taken into consideration, but often separately. Here, we entered demographic, anthropometric, subjective, and objective sleep- and breathing-related dimensions in one model. Methods: We reviewed the demographic, anthropometric, subjective and objective sleep- and breathing-related data, and polysomnographic records of 251 individuals with diagnosed OSA. OSA was considered as a continuous and as categorical variable (mild, moderate, and severe OSA). A series of correlational computations, X2-tests, F-tests, and a multiple regression model were performed to investigate which demographic, anthropometric, and subjective and objective sleep dimensions were associated with and predicted dimensions of OSA. Results: Higher apnea/hypopnea index (AHI) scores were associated with higher BMI, higher daytime sleepiness, a higher respiratory disturbance index, and higher snoring. Compared to individuals with mild to moderate OSA, individuals with severe OSA had a higher BMI, a higher respiratory disturbance index (RDI) and a higher snoring index, while subjective sleep quality and daytime sleepiness did not differ. Results from the multiple regression analysis showed that an objectively shorter sleep duration, more N2 sleep, and a higher RDI predicted AHI scores. Conclusion: The pattern of results suggests that blending demographic, anthropometric, and subjective/objective sleep- and breathing-related data enabled more effective discrimination of individuals at higher risk for OSA. The results are of practical and clinical importance: demographic, anthropometric, and breathing-related issues derived from self-rating scales provide a quick and reliable identification of individuals at risk of OSA; objective assessments provide further certainty and reliability.

Abstract P068: Obstructive Sleep Apnea is Associated with an Increase Risk of Osteoporosis

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Anawin Sanguankeo ◽  
Sikarin Upala
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Systemic Disease ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Increase Risk ◽  
Osteoporosis Risk ◽  
Stimulation Of

Background: Obstructive sleep apnea (OSA) is thought to be a systemic disease and has been associated with many disorders such as metabolic, endocrine, and especially cardiovascular diseases. One of the consequences of OSA is hypoxia, which can lead to a reduction in growth of osteoblast and a stimulation of osteoclast. Our meta-analysis was conducted to determine the risk of osteoporosis in patients with OSA compared to controls. Objectives: Eligible studies assessing the effects of obstructive sleep apnea on osteoporosis risk were comprehensively searched in PubMed/MEDLINE, EMBASE, and CENTRAL from their inception to September 2014. Two authors independently assessed article quality and extracted the data. Primary outcome were number of participants, prevalence, or risk ratio of osteoporosis in OSA and controls. Results: From 40 full-text articles, 3 studies involving 113,090 participants were included in the meta-analysis that were based on the random effects model. Compared with controls, participants who were diagnosed with obstructive sleep apnea had increased risk of osteoporosis (pooled risks ratio, 1.85; 95% CI, 1.34, 2.56). Conclusion: Patients with OSA had a higher risk of developing osteoporosis. Further study is needed to evaluate the possible mechanisms between these two conditions and to find potential treatment for OSA that could prevent osteoporosis.

Increased Risk for Cancer in Young Patients with Severe Obstructive Sleep Apnea

Respiration ◽  
2018 ◽  
Vol 97 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Ronen Brenner ◽  
Shaye Kivity ◽  
Marina Peker ◽  
Daniel Reinhorn ◽  
Lital Keinan-Boker ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Young Patients ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Increased Risk

scholarly journals Obstructive sleep apnea syndrome and cognitive impairment: effects of CPAP

2011 ◽  
Vol 2 (4) ◽  
pp. 209
Author(s):  
Alessandra Giordano ◽  
Alessandro Cicolin ◽  
Roberto Mutani
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cognitive Impairment ◽  
Sleep Apnea ◽  
Executive Functions ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Muscular Activity ◽  
Upper Airways ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder characterised by repetitive episodes of upper airway obstruction (apnea) or reduced airflow (hypopnoea) despite persistent respiratory effort. Apnea is defined as the cessation of breathing for at least 10 seconds during sleep, while hypopnoea is defined as at least 30% reduction in airflow for 10 seconds associated with oxygen desaturation and sleep fragmentation. The presence in the general population is about 4%. The principal symptoms are: excessive daytime sleepiness (EDS), snoring, dry throat, morning headache, night sweats, gastro-esophageal reflux, and increased blood pressure.Long term complications can be: increased cardio-cerebrovascular risk and cognitive impairment such as deficiency in attention, vigilance, visual abilities, thought, speech, perception and short term memory.Continuous Positive Airway Pressure (CPAP) is currently the best non-invasive therapy for OSAS.CPAP guarantees the opening of upper airways using pulmonary reflexive mechanisms increasing lung volume during exhalation and resistance reduction, decreasing electromyografical muscular activity around airways.The causes of cognitive impairments and their possible reversibility after CPAP treatment have been analysed in numerous studies. The findings, albeit controversial, show that memory, attention and executive functions are the most compromised cognitive functions.The necessity of increasing the patient compliance with ventilotherapy is evident, in order to prevent cognitive deterioration and, when possible, rehabilitate the compromised functions, a difficult task for executive functions.

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