A descriptive study: Psychiatric diseases accompanying obstructive sleep apnea syndrome (OSAS); [Tanimlayici bir çalişma: Obstrüktif uyku apne sendromuna (OSAS) eşlik eden psikiyatrik hastaliklar]

Bakar E.E.; Yilmaz H.

A descriptive study: Psychiatric diseases accompanying obstructive sleep apnea syndrome (OSAS); [Tanimlayici bir çalişma: Obstrüktif uyku apne sendromuna (OSAS) eşlik eden psikiyatrik hastaliklar]

Date

2008

Authors

Bakar E.E.

Yilmaz H.

Abstract

Purpose: OSAS is a disease which involves a wide range of symptoms from simple snoring extending up to the tables accompanied by serious cardiovascular, pulmonary, endocrine and psychiatric diseases. In our study; we aimed to look into the variety of the psychiatric diseases observed in patients with diagnosis of OSAS and to discuss the spectrum of psychiatric diseases accompanied by the typical clinical symptoms and findings in light of literature. Methods: The cases who visited our outpatient clinic in between 2004-2007 and reveived preliminary diagnosis of OSAS were inspected all night through video-EEG-polysomnography by certificated sleep technicians using devices of Embla A-10, N-7000Ë in accordance with sleep apnea protocol in order to trace the change in sleep structure and breathing events. All the cases were assessed by a psychiatric expert and those who had the diagnosis of psychiatric disease according to the criteria of DSM IV were included in the study. Results: Of 235 cases, in 23.8%, there found to have at least one comorbid psychiatric disease. In these cases, the frequency of the depression was 92.8%, schizophrenia was 7.1%, OCD (obsessive compulsive disorder) was 3.5%, and bipolar disorder - depressive episode was 1.7%. OSAS and the sleep structure of the cases having psychiatric disorders were investigated. AHI (Apnea-hypopnea index) increased in 68% of the cases. Discussion: The sleep continuity in OSAS gets broken and is fragmental. The superficial sleep duration increases, deep sleep and REM sleep get suppressed. In such psychiatric diseases as depression difficulty in falling asleep, destruction in sleep integrity due to the frequent wake-ups are observed. In generalized anxiety disorder and schizophrenia, a fragmental sleep and decrease in sleep efficiency are observed. When the psychiatric disease is accompanied by OSAS, high rate of AHI are frequently encountered. Conclusion: Our study examines the variety of the psychiatric diseases observed in patients with diagnosis of OSAS and makes discussions in light of the psychiatric disease spectrum literature data accompanying the OSAS clinic. Similar studies in bigger serials will ensure the psychiatric disease spectrum seen in cases with OSAS to be understood and diversities in approach against these cases to get clarified.