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CPAP-induced mania in bipolar disorder: a case report
Richa Aggarwal1, Raman Baweja, Erika Fh Saunders
1Department of Psychiatry, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
Bipolar Disorders
|August 29, 2013
Summary
Continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) in bipolar disorder patients unexpectedly triggered manic symptoms in two cases. Close monitoring for mood changes during CPAP treatment is crucial.
Area of Science:
- Psychiatry and Sleep Medicine
- Investigating the complex interplay between mental health disorders and sleep disturbances.
Background:
- Bipolar disorder affects mood regulation, characterized by mania and depression.
- Obstructive sleep apnea (OSA) is a common sleep disorder, with higher prevalence in obese individuals.
- High comorbidity of OSA is anticipated in bipolar disorder due to associated obesity, yet data on CPAP's impact is limited.
Observation:
- Two patients with bipolar disorder and diagnosed OSA were initiated on continuous positive airway pressure (CPAP) therapy.
- Polysomnography confirmed OSA, and CPAP titration effectively reduced apneas/hypopneas and improved oxygen saturation.
Findings:
- Initiation of CPAP treatment led to the emergence of manic symptoms in both bipolar disorder patients.
- This paradoxical response highlights an unexpected clinical observation in the treatment of comorbid OSA in this population.
Implications:
- Clinicians must exercise vigilance when prescribing CPAP for OSA in patients with bipolar disorder.
- Close monitoring for exacerbation of manic symptoms is essential during CPAP initiation and titration.
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