Benca Ruth M, Krystal Andrew, Chepke Craig, Doghramji Karl
Psychiatry and Behavioral Medicine, Wake Forest University, Winston Salem, North Carolina.
Corresponding author: Ruth M. Benca, MD, PhD, Department of Psychiatry, Wake Forest School of Medicine, Atrium Health Wake Forest Baptist, 791 Jonestown Rd, Winston-Salem, NC 27103 (
J Clin Psychiatry. 2023 Jan 23;84(2):22r14521. doi: 10.4088/JCP.22r14521.
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.
本综述的目的是描述阻塞性睡眠呼吸暂停（OSA）与精神障碍之间的关系，并概述在精神科实践中如何识别/管理OSA。我们对PubMed进行了文献检索（针对成年人，英文，不限年份）。主要关键词包括“阻塞性睡眠呼吸暂停”和“精神科”等。手动筛选了与精神科人群中OSA治疗相关的文章。未进行正式的数据图表分析。文献检索共纳入141篇文章。OSA共病在精神障碍患者中很常见，尤其是抑郁症和创伤后应激障碍患者。有证据表明，OSA可能是精神疾病发生以及精神科人群自杀意念和自杀企图的独立危险因素。由于OSA、精神障碍和精神科药物副作用之间存在症状重叠（如睡眠问题、情绪变化和植物神经症状），识别精神障碍患者中的OSA具有挑战性。未经充分治疗的OSA会影响精神症状的严重程度，并损害对精神科治疗的反应。临床医生不应假定所有与睡眠相关的症状都是精神疾病或药物的后果，而应认识到可能存在需要治疗的共存OSA。识别和管理精神障碍患者中的OSA对于改善治疗反应、生活质量和整体健康至关重要。
