Recognition and Management of Obstructive Sleep Apnea in Psychiatric Practice.

The aims of this review were to describe the relationship between obstructive sleep apnea (OSA) and psychiatric disorders and provide an overview of how to recognize/manage OSA in psychiatric practice. A literature search of PubMed was conducted (in adults, English language, no limitation on year). Among others, main keywords included "obstructive sleep apnea" AND "psychiatric." Articles relevant to the treatment of OSA in psychiatric populations were selected manually. No formal data charting was conducted. A total of 141 articles were included from the literature search. Comorbid OSA is common among patients with psychiatric disorders, particularly depression and posttraumatic stress disorder. Evidence suggests that OSA may be an independent risk factor for the development of psychiatric conditions, as well as for suicidal ideation and attempts in psychiatric populations. Recognizing OSA in patients with psychiatric disorders can be challenging due to the overlap of symptoms (eg, sleep issues, mood changes, and vegetative symptoms) between OSA, psychiatric disorders, and side effects of psychiatric medications. Inadequately treated OSA can affect the severity of psychiatric symptoms and impair response to psychiatric treatment. Clinicians should not assume that all sleep-related symptoms are consequences of psychiatric illness or medication but should instead be cognizant of the potential for coexisting OSA that requires treatment. Recognizing and managing OSA in patients with psychiatric disorders are critical to improve response to treatment, quality of life, and overall health.