Winkelman J W
Sleep Disorders Program, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02459, USA.
J Clin Psychiatry. 2001 Jan;62(1):8-11. doi: 10.4088/jcp.v62n0103.
This study evaluated the risk factors for obstructive sleep apnea in psychiatric patients.
The subjects were 364 patients referred to a sleep disorders consultation service from an inpatient psychiatric hospital. Seventy-eight percent underwent polysomnographic testing. Rates of obstructive sleep apnea in different diagnostic groups (established by clinical DSM-III-R diagnosis) were retrospectively assessed.
Logistic regression demonstrated significant independent effects of age (p = .046), gender (p = .002), body mass index (p < .001), and chronic neuroleptic use (p = .012) on the presence of obstructive sleep apnea (defined as more than 20 instances of apnea and/or hypopnea per hour of sleep). Patients with schizophrenia were significantly heavier and had higher rates of sleep apnea than did other psychiatric patients.
Obesity, male gender, and chronic neuroleptic administration are risk factors for obstructive sleep apnea in psychiatric patients. Since patients with schizophrenia are often on long-term neuroleptic treatment, they may have high rates of obstructive sleep apnea, mediated via the weight gain produced by such medications. Overweight psychiatric patients and those on chronic neuroleptic treatment (e.g., patients with schizophrenia) should be evaluated for sleep apnea if signs and symptoms of this disorder are present.
本研究评估了精神科患者阻塞性睡眠呼吸暂停的危险因素。
研究对象为364名来自一家住院精神科医院睡眠障碍咨询服务处的患者。78%的患者接受了多导睡眠图测试。回顾性评估不同诊断组（根据临床DSM-III-R诊断确定）的阻塞性睡眠呼吸暂停发生率。
逻辑回归显示年龄（p = .046）、性别（p = .002）、体重指数（p < .001）和长期使用抗精神病药物（p = .012）对阻塞性睡眠呼吸暂停（定义为每小时睡眠中呼吸暂停和/或呼吸不足超过20次）的存在有显著独立影响。精神分裂症患者比其他精神科患者体重更重，睡眠呼吸暂停发生率更高。
肥胖、男性性别和长期使用抗精神病药物是精神科患者阻塞性睡眠呼吸暂停的危险因素。由于精神分裂症患者通常接受长期抗精神病药物治疗，他们可能有较高的阻塞性睡眠呼吸暂停发生率，这是由此类药物导致的体重增加介导的。如果存在该疾病的体征和症状，超重的精神科患者以及接受长期抗精神病药物治疗的患者（如精神分裂症患者）应接受睡眠呼吸暂停评估。
