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J Affect Disord. 2013 Oct;151(1):54-8. doi: 10.1016/j.jad.2013.05.047. Epub 2013 Jun 12.

The high prevalence of obstructive sleep apnea among patients with bipolar disorders.

Author information

1
Depression & Biploar Clinic of Colorado, 400 East Horsetooth Road, Suite 300, Fort Collins, Colorado 80525, USA. TamKelly@comcast.net

Abstract

INTRODUCTION:

Sleep plays an important role in maintaining stability in bipolar disorders, and sleep disturbances can trigger mood episodes. Obstructive sleep apnea (OSA) is a common sleep disorder, yet the co-occurrence with bipolar disorder has not been methodically studied.

METHODS:

This is a chart review of 482 consecutively seen patients with a bipolar disorder who underwent routine screening for OSA using a self-report sleep apnea questionnaire. Positive screens were referred for a sleep study.

RESULTS:

A positive screen was found in 214 (44.4%) patients. Sleep studies were obtained on 114 patients, and 101, were diagnosed with OSA: point prevalence 21%.

DISCUSSION:

The 21% prevalence fails to consider the false negative rate of the questionnaire, or the exclusion of patients who screened positive but failed to get a sleep study. Taking these into consideration it is estimated that the true prevalence of OSA in this study may be as high as 47.5%. The co-occurrence of OSA and bipolar disorders is markedly higher than previously thought. Of note, OSA may play a role in refractory bipolar, disorders, and carries significant mortality and morbidity that overlap, with the mortality and morbidity found with bipolar disorders.

LIMITATIONS:

This was a retrospective study based on a self-report questionnaire. Polysomnographic confirmation was performed in only a subgroup of subjects.

CONCLUSIONS:

The data suggest that unrecognized OSA may play a major role in the mortality and morbidity of bipolar disorders. All patients diagnosed with a bipolar disorder should be screened with an OSA questionnaire.

KEYWORDS:

Bipolar I; Bipolar II; Screening instrument; Sleep apnea; Sleep disorder

PMID:
23769606
DOI:
10.1016/j.jad.2013.05.047
[Indexed for MEDLINE]

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