Risk of obstructive sleep apnea in patients with schizophrenia: a nationwide population-based cohort study

Patients with schizophrenia (SCZ) have a higher prevalence of known risk factors for obstructive sleep apnea (OSA). This study aims to determine if SCZ patients are at increased risk of incident OSA.

A total of 5092 newly diagnosed SCZ patients and 5092 non-SCZ controls matched by gender, age, and index year were included between 2000 and 2012 and followed to 2013. Participants newly diagnosed with OSA were defined as incidents. Cox regression analysis was used to calculate the hazard ratio (HR) with 95% confidence intervals (CI) of the OSA incidence rate between the two groups studied.

SCZ patients were at increased risk of OSA compared to non-SCZ controls after adjusting for gender, age, comorbidities, and duration of antipsychotic use (2.12 versus 1.01 per 1000 person-years, HR: 1.97, 95% CI: 1.36-2.85). Also, this study confirmed the existence of some known risk factors for OSA, including male gender (HR 1.65, 95% CI 1.14-2.37), obesity (HR 2.62, 95% CI 1.19-5.80), hypertension (HR 1.61, 95% CI 1.06-2.47), hyperlipidemia (HR 1.55, 95% CI 1.04-2.38), diabetes (HR 1.53, 95% CI 1.01-2.38), and antipsychotic use (duration < 1 year (HR 1.57, 95% CI 1.13-2.37), 1-3 years (HR 1.62, 95% CI 1.06-2.82), and 3-5 years (HR 1.45, 95% CI 1.06-2.44)).

This study shows SCZ patients are at increased risk of OSA, and there is still an association with higher risk of OSA after controlling for known risk factors, indicating that it is necessary to develop targeted interventions in SCZ patients to reduce the negative impact of OSA on health.