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Pilot cohort study of obstructive sleep apnoea in community-dwelling people with schizophrenia

Published online by Cambridge University Press:  24 April 2020

H. Myles ,
N. Myles ,
A. D. Vincent ,
G. Wittert ,
R. Adams ,
M. Chandratilleke ,
D. Liu ,
J. Mercer ,
A. Vakulin  and
C. L. Chai-Coetzer
...Show all authors
H. Myles*
Affiliation:
Adelaide Medical School, Adelaide University, 4 North Terrace, Adelaide, South Australia, Australia Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
N. Myles
Affiliation:
The Royal Adelaide Hospital, Port Road, Adelaide, South Australia, Australia
A. D. Vincent
Affiliation:
Adelaide Medical School, Adelaide University, 4 North Terrace, Adelaide, South Australia, Australia Freemasons Foundation Centre for Men’s Health, 254 North Terrace, Adelaide, South Australia, Australia
G. Wittert
Affiliation:
Adelaide Medical School, Adelaide University, 4 North Terrace, Adelaide, South Australia, Australia Freemasons Foundation Centre for Men’s Health, 254 North Terrace, Adelaide, South Australia, Australia
R. Adams
Affiliation:
Adelaide Medical School, Adelaide University, 4 North Terrace, Adelaide, South Australia, Australia The Health Observatory, Discipline of Medicine, 37 Woodville Rd, Woodville South, South Australia, Australia
M. Chandratilleke
Affiliation:
Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Sturt Road, Adelaide, South Australia, Australia
D. Liu
Affiliation:
Adelaide Medical School, Adelaide University, 4 North Terrace, Adelaide, South Australia, Australia Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
J. Mercer
Affiliation:
Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Sturt Road, Adelaide, South Australia, Australia
A. Vakulin
Affiliation:
Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Sturt Road, Adelaide, South Australia, Australia NeuroSleep and Woolcock Institute of Medical Research, University of Sydney, 431 Glebe Point Rd, Glebe, New South Wales, Australia
C. L. Chai-Coetzer
Affiliation:
Adelaide Institute for Sleep Health: A Flinders Centre for Research Excellence, Flinders University, Sturt Road, Adelaide, South Australia, Australia Sleep Health Service, Southern Adelaide Local Health Network, South Australia, Australia
C. Galletly
Affiliation:
Adelaide Medical School, Adelaide University, 4 North Terrace, Adelaide, South Australia, Australia Northern Adelaide Local Health Network, Adelaide, South Australia, Australia Ramsey Health Care (SA) Mental Health, The Adelaide Clinic, 33 Park Tce, Gilberton, South Australia, Australia
*
*Address for correspondence: Dr Hannah Myles, Adelaide Medical School, Adelaide University, 4 North Terrace, Adelaide, South Australia, Australia. (Email: Hannah.myles@sa.gov.au)
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Abstract

Objectives:

We aimed to assess the incidence of obstructive sleep apnoea (OSA) in people with schizophrenia, to explore clinical associates with OSA and how well OSA screening tools perform in this population.

Methods:

All patients registered in a community outpatient Clozapine clinic, between January 2014 and March 2016, were consecutively approached to participate. Participants were screened for OSA using at home multichannel polysomnography (PSG) and were diagnosed with OSA if the apnoea-hypopnoea index (AHI) was >10 events/hr. Univariate comparison of participants to determine whether AHI > 10 events/hr was associated with demographic factors, anthropometric measures and psychiatric symptoms and cognition was performed. The sensitivity, specificity, positive predictive value and negative predictive value of the commonly used sleep symptoms scales and OSA screening tools were also determined.

Results:

Thirty participants were recruited, 24 men and 6 women. Mean age was 38.8 (range: 25–60), and mean body mass index (BMI) was 35.7 (range 19.9–62.1). The proportion of participants with OSA (AHI > 10 events/hr) was 40%, 18 (60%) had no OSA, 4 (13%) had mild OSA (AHI 10.1–20), zero participants had moderate OSA (AHI 20.1–30) and 8 (27%) had severe OSA (AHI > 30). Diagnosis of OSA was significantly associated with increased weight, BMI, neck circumference and systolic blood pressure. Diagnosis of OSA was not significantly associated with Positive and Negative Symptoms Scale, Montgomery Asperger’s Depression Rating Scale, Personal and Social Performance scale or Brief Assessment of Cognition for Schizophrenia scores. All OSA screening tools demonstrated poor sensitivity and specificity for a diagnosis of OSA.

Conclusion:

OSA was highly prevalent in this cohort of people with schizophrenia and was associated with traditional anthropometric OSA risk factors.

Keywords

Clozapineobstructive sleep apnoeaschizophreniasleep apnoea
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 38 , Issue 1: Themed Issue: Physical Health in Mental Illness , March 2021 , pp. 23 - 29
Copyright
© College of Psychiatrists of Ireland 2020

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