Department of Psychiatry, Dartmouth Medical School, Hanover, NH, USA.
Sleep Med. 2011 Jun;12(6):591-7. doi: 10.1016/j.sleep.2010.12.013.
Limited evidence links atypical antipsychotics (AAs) use to sleep related respiratory dysfunction and greater severity of obstructive sleep apnea (OSA). The present paper reviews the published evidence and examines the impact of AA use on the presence and severity of OSA among subjects with clinically suspected OSA after adjusting for several confounds.
Archives of the University of Iowa Sleep Laboratory from 2005 to 2009 were searched for patients using AAs at the time of diagnostic polysomnogram (PSG). PSG data of the 84 AA users with heterogeneous psychiatric disorders (of these 20 diagnosed only with depression) were subsequently compared to PSG data of two randomly selected, non-AA user groups from the same patient pool: (i) 200 subjects with a depressive disorder as the only psychiatric diagnosis, and (ii) 331 mentally healthy controls. PSG data were analyzed adjusting for known demographic, medical, and psychiatric risk factors for OSA.
Prevalence and severity of OSA did not differ significantly across three groups. Sex, age, body mass index (BMI), and neck circumference (NC) independently predicted OSA. Odds ratio for OSA in the subset of AA users carrying the diagnosis of depression (n=20) compared with subjects without mental illness was 4.53 (p<.05). By contrast, AA users without depression or those with multiple psychiatric diagnoses including depression did not show a statistically significantly elevated OSA risk.
AA use in subjects with depression appears to increase the risk of OSA after controlling for known predisposing factors.
有限的证据表明，非典型抗精神病药物（AAs）的使用与睡眠相关的呼吸功能障碍和阻塞性睡眠呼吸暂停（OSA）的严重程度有关。本文综述了已发表的证据，并在调整了几个混杂因素后，研究了 AAs 使用对临床疑似 OSA 患者 OSA 的存在和严重程度的影响。
检索 2005 年至 2009 年爱荷华大学睡眠实验室的档案，寻找在诊断性多导睡眠图（PSG）检查时使用 AAs 的患者。随后，将 84 名患有各种精神疾病（其中 20 名仅被诊断为抑郁症）的 AAs 使用者的 PSG 数据与来自同一患者群体的两个随机选择的非 AAs 使用者组的 PSG 数据进行比较：（i）200 名仅有抑郁障碍的精神疾病患者，以及（ii）331 名心理健康对照者。通过调整已知的 OSA 发生的人口统计学、医学和精神风险因素，对 PSG 数据进行了分析。
三组患者的 OSA 患病率和严重程度无显著差异。性别、年龄、体重指数（BMI）和颈围（NC）独立预测 OSA。与无精神疾病的患者相比，仅患有抑郁症的 AA 使用者亚组的 OSA 患病风险比为 4.53（p<.05）。相比之下，无抑郁或患有包括抑郁症在内的多种精神疾病诊断的 AA 使用者并未显示出统计学上显著升高的 OSA 风险。
在控制已知的易患因素后，抑郁症患者使用 AAs 似乎会增加 OSA 的风险。
