Seeman Mary V
Department of Psychiatry, University of Toronto , Ontario , Canada.
J Ment Health. 2014 Aug;23(4):191-6. doi: 10.3109/09638237.2013.869572. Epub 2014 Jan 16.
Obstructive sleep apnoea (OSA) is often overlooked in the context of schizophrenia because its hallmark, daytime sleepiness, is so easily attributable to antipsychotic drugs. This is a special problem for women.
To underscore the importance of diagnosing and treating OSA in women with schizophrenia.
A review of the recent literature (search terms: Obstructive Sleep Apnoea; Schizophrenia; Women (or Gender); Obesity; Antipsychotics; Continuous Positive Airway Pressure (CPAP)) as it applies to a composite case vignette taken from the files of a specialty clinic that treats women with psychosis.
The rate of OSA in women who are both obese and postmenopausal is very similar to that of men. Family history, smoking, and the use of tobacco, alcohol and of antipsychotic medication increase the risk. Despite reluctance, patients with schizophrenia generally agree to undergo sleep studies. Compliance with CPAP is difficult, but can be aided by the physician and is, on the whole, relatively high in women. CPAP improves sleep parameters and may also improve cardiometabolic and cognitive indices, although this still needs to be more fully researched.
Schizophrenia and untreated OSA are both associated with high mortality rates in women as well as men.
在精神分裂症背景下，阻塞性睡眠呼吸暂停（OSA）常常被忽视，因为其标志性症状日间嗜睡很容易归因于抗精神病药物。这对女性来说是个特殊问题。
强调在患有精神分裂症的女性中诊断和治疗OSA的重要性。
对近期文献进行综述（检索词：阻塞性睡眠呼吸暂停；精神分裂症；女性（或性别）；肥胖；抗精神病药物；持续气道正压通气（CPAP）），这些文献适用于取自一家治疗患有精神病女性的专科诊所档案中的一个综合病例 vignette。
肥胖且绝经后的女性中OSA的发生率与男性非常相似。家族史、吸烟以及烟草、酒精和抗精神病药物的使用会增加风险。尽管不情愿，但精神分裂症患者通常同意接受睡眠研究。持续气道正压通气（CPAP）的依从性较差，但医生可以提供帮助，总体而言，女性的依从性相对较高。CPAP可改善睡眠参数，也可能改善心脏代谢和认知指标，不过这仍需要更充分的研究。
精神分裂症和未经治疗的OSA在女性和男性中均与高死亡率相关。
