Screening for obstructive sleep apnea among individuals with severe mental illness at a primary care clinic

Obstructive sleep apnea (OSA) is linked to significant morbidity and mortality. OSA has received more attention recently, but the literature on OSA is scant in patients with severe mental illness (SMI). This project was undertaken to improve clinician knowledge and screening of OSA in persons with SMI.

One hundred SMI patients attending a primary care clinic were screened for symptoms and risk factors associated with OSA. The Epworth Sleepiness Scale was used to assess daytime sleepiness, and the STOP-Bang score was used to classify those at high risk for OSA.

Sixty-nine percent of patients were found to be at high risk for OSA. Sixteen percent had a previously confirmed diagnosis of OSA. Most patients reported that OSA was never discussed with them, and 71% of those at high risk were willing to be referred for a sleep evaluation.

Patients with SMI are at high risk for OSA, and screening for OSA appears to be inadequate. This screening can be done easily, seems acceptable to patients and may prove very beneficial as OSA diagnosis and treatment can improve mental and physical health outcomes in SMI patients.