Risk of obstructive sleep apnea and excessive daytime sleepiness in hospitalized psychiatric patients

Abstract

Objectives: This study evaluated the risk of developing obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) in hospitalized psychiatric patients at the American University of Beirut Medical Center (AUB-MC). Factors associated with OSA and EDS occurrence in this sample were also examined. Methods: The Berlin questionnaire and the Epworth sleepiness scale; which respectively evaluate OSA and EDS symptoms, were administered to individuals hospitalized at an acute psychiatric treatment unit at the AUB-MC between the dates of January 2014 and October 2016. Additional data collected included general demographics, psychiatric diagnoses, and questionnaires evaluating depression and anxiety symptoms. Statistical analyses utilizing SPSS were performed to determine the prevalence of OSA and EDS, as well as their respective associations with patient profiles. Results: Our results showed that 39.5% of participants were found to have a high risk of sleep apnea and 9.9% of the participants were found to have abnormal daytime sleepiness. The risk of developing OSA was associated with a higher body mass index (BMI) ( P =0.02), and depression severity (patient health questionnaire 9 score) ( P =0.01). Increasing severity of depressive symptoms was associated with a higher risk of sleep apnea ( P =0.01). BMI (odds ratio [OR] =5.97, 95% confidence interval [CI] 1.89–18.82) and depression severity (OR =4.04, 95% CI 1.80–9.07) were also found to be predictors of OSA. The psychiatric diagnoses of the participants were not found to have a significant association with the risk of sleep apnea. Conclusion: The risk of OSA is increased among hospitalized psychiatric patients, and this condition can have detrimental effects on psychiatric patients. OSA appears to be under-recognized in this population, psychiatrists should screen for OSA in hospitalized psychiatric patients and refer them for diagnostic testing or treatment when indicated. Keywords: obstructive sleep apnea, excessive daytime sleepiness, depression, anxiety, psychiatric patients, inpatient psychiatry