BD I patients at high risk for sleep apnea

By Mark Cowen, Senior medwireNews Reporter

Around half of overweight patients with bipolar I disorder (BD I) are at high risk for developing obstructive sleep apnea (OSA), US study results suggest.

The team also found that BD I patients at high risk for OSA had greater levels of depression and mania than BD I patients at low risk for the sleep disorder.

"Our results indicate that an evaluation of sleep apnea risk factors should be considered for patients with BD, particularly those who have chronic mood symptoms," say Isabella Soreca and colleagues from the University of Pittsburgh School of Medicine in Pennsylvania.

The researchers studied 72 overweight (body mass index ≥25 kg/m²) outpatients with remitted BD I who were receiving maintenance treatment.

Risk for OSA (high or low) was assessed using the Berlin Questionnaire, which contains 10 questions in three categories. Category one defines high risk as persistent symptoms of snoring, category two as persistent occurrences of daytime sleepiness and/or drowsy driving, and category three as the presence of hypertension or obesity. Individuals are considered at high risk for OSA if they meet high-risk criteria in two of the three categories.

The patients were also assessed for depression and mania severity using the Hamilton Rating Scale for Depression (HAM-D) and the Mania Rating Scale (YMRS).

As reported in Bipolar Disorders, 54.1% (n=39) of the participants met criteria for being at high risk for OSA.

The researchers also found that patients in the high-risk group had significantly higher mean HAM-D and YMRS scores than low-risk patients, at 13.10 versus 6.30 and 3.10 versus 1.50, respectively.

This difference in HAM-D and YMRS scores remained significant even after sleep items from both rating scales were removed, at 9.82 versus 4.30 and 2.79 versus 1.36, respectively.

"In spite of the recent increase in the prevalence of sleep apnea in the general population and the increased sensitivity of clinicians to the problem, apnea has been surprisingly neglected in patients with BD," comment the researchers.

They conclude: "Considering the substantial overlap between symptoms of OSA and symptoms of depression and the potentially harmful effects of sleep disruption in patients with mood disorders, a systematic screening to assess the prevalence and associated features of OSA in patients with BD is clearly warranted."

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