Thursday, September 26, 2019

Sleep Apnea in Veterans With Serious Mental Illness Linked to Other Comorbidities

People with serious mental illness (SMI) and sleep apnea (a condition that causes breathing to stop and start repeatedly throughout the night) have a higher rate of general medical and psychiatric comorbidities than people with SMI and no sleep apnea, according to a study published in Psychosomatics.

“Appropriate detection, diagnosis, and management of sleep apnea may help to reduce morbidity and mortality risk in individuals with SMI,” wrote Isabella Soreca, M.D., of the VA Pittsburgh Healthcare System and colleagues.

The researchers used an administrative dataset of 33,818 U.S. veterans who visited a primary care doctor at the Department of Veterans Affairs in Pittsburgh in 2007. They analyzed medical records from 2001 to 2011 of this group of patients; these records included general medical, psychiatric, and sleep diagnoses. SMI diagnoses were defined using the International Classification of Diseases (ICD-9) codes for schizophrenia, schizoaffective disorder, and/or bipolar disorder. A sleep apnea diagnosis was defined by the presence of two or more lifetime diagnoses of a breathing-related sleep disorder. Researchers evaluated whether the patient had a chronic condition associated with sleep apnea, such as a cardiac, hypertension, vascular, respiratory, upper gastrointestinal, and/or endocrine-metabolic condition.

Of the veterans with SMI, 13.7% also had sleep apnea; 8.4% of those without SMI had sleep apnea.

“On average, veterans with both SMI and sleep apnea had a significantly higher number of medical comorbidities than those with SMI but no sleep apnea, as well as those with sleep apnea but no SMI,” the researchers wrote. Additionally, those with SMI had a notably higher rate of chronic medical comorbidities even though they were generally younger than those without SMI. Of those with SMI, 19% were between the ages of 40 and 49, compared to just 6% of those without SMI.

“[O]ur data show high prevalence of sleep apnea in veterans with SMI, even in younger groups,” Soreca and colleagues wrote. “The higher prevalence of sleep apnea at an earlier age could be one of the pathways to high cardiovascular morbidity and premature mortality in veterans with SMI and may offer a new target intervention for risk reduction.”

For related information, see the American Journal of Psychiatry Residents’ Journal article “Screening for Sleep Apnea in Psychiatry.”

(Image: iStock/Tero Vesalainen)

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