The Population Based Risk of Obstructive Sleep Apnea and Psychiatric Conditions

This study investigates the association between obstructive sleep apnea (OSA) and the risk of developing psychiatric disorders. OSA, characterized by intermittent hypoxia and sleep fragmentation, contributes to brain damage and emotional regulation issues, which may predispose individuals to psychiatric conditions such as depression, anxiety, bipolar disorder, and schizophrenia. The research focuses on understanding the heightened risks of these disorders in OSA patients to inform clinical interventions. To assess the risk differences for psychiatric disorders in patients with OSA compared to those without OSA.

The study utilized a retrospective cohort design, analyzing de-identified electronic health records (EHRs) from the TriNetX US Network. Data from 7,079,095 individuals (aged 18-65 years) were included. After exclusion (prior psychiatric disorders, circadian rhythm disorders, central sleep apnea, pregnancy, or death before index date), 368,125 OSA patients and 4,396,092 non-OSA individuals remained eligible. Following propensity score matching (PSM), 360,708 patients per group were analyzed. divided into OSA (368,125 patients) and non-OSA (4,396,092 patients) cohorts. PSM (360,708 patients per group) was applied to balance baseline characteristics. The primary outcome was the 8-year risk of newly diagnosed psychiatric disorders, analyzed using Cox proportional hazards models.

Patients with OSA showed significantly higher cumulative probabilities for psychiatric disorders over 8 years: depressive disorders: 27.4% in OSA patients vs. 15.8% in non-OSA patients (hazard ratio [HR]: 1.913). Anxiety disorders: 37.4% in OSA patients vs. 25.4% in non-OSA patients (HR: 1.663). Bipolar disorder: increased risk in OSA patients (HR: 1.885). Schizophrenia: minimal differences between groups (HR: 0.971). Subgroup analyses revealed that younger individuals and those with higher BMI were at greater risk for psychiatric disorders.

OSA significantly elevates the risk of psychiatric disorders, particularly depression and anxiety. These findings emphasize the need for targeted screening and management strategies for high-risk populations, including younger and overweight individuals.