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The prevalence and predictors of obstructive sleep apnea in major depressive disorder, bipolar disorder and schizophrenia: A systematic review and meta-analysis

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Brendon Stubbs, Davy Vancampfort, Nicola Veronese, Marco Solmi, Fiona Gaughran, Peter Manu, Simon Rosenbaum, Marc De Hert, Michele Fornaro

Original languageEnglish
JournalJournal of Affective Disorders
Early online date9 Mar 2016
Accepted/In press26 Feb 2016
E-pub ahead of print9 Mar 2016


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    1_s2.0_S0165032715311939_main.pdf, 1,000 KB, application/pdf

    Uploaded date:10 Mar 2016

    Version:Accepted author manuscript

King's Authors


AbstractBackground Obstructive sleep apnea (OSA) is a health hazard since it is associated with neurocognitive dysfunction and cardio-metabolic diseases. The prevalence of OSA among people with serious mental illness (SMI) is unclear. Method We searched major electronic databases from inception till 06/2015. Articles were included that reported the prevalence of OSA determined by polysomnography (PSG) or an apnea-hypopnea index (AHI) >5 events/hr, in people with major depressive disorder (MDD), bipolar disorder (BD) or schizophrenia. A random effects meta-analysis calculating the pooled prevalence of OSA and meta-regression of potential moderators were performed. Results Twelve articles were included representing 570,121 participants with SMI (mean age=38.3 years (SD=7.5)), 45.8% male (range=32-80.4) and mean body mass index (BMI) 25.9 (SD=3.7). The prevalence of OSA in SMI in clinical studies was 25.7% (95% CI 13.9 to 42.4%, n=1,535). Higher frequencies of OSA were seen in MDD (36.3%, 19.4 - 57.4%, n=525) than in BD (24.5%, 95% CI 10.6 - 47.1, n=681) and schizophrenia (15.4%, 95% CI 5.3 - 37.1%, n=329). The prevalence of OSA in 568,586 people with SMI from population cohort studies was 10.7% (95% CI 2.4 - 37.0%) and 19.8% (95% CI 2.5 - 70.0%) in 358,853 people with MDD. Increasing age (β=0.063, 95% CI 0.0005 -0.126, p=0.04, N=10) and BMI predicted increased prevalence of OSA (β=0.1642, 95% CI 0.004 - 0.3701, p=0.04, N=9). Conclusion People with SMI (particularly MDD) have a high prevalence of OSA. Screening for and interventions to manage OSA in SMI including those focused on reducing BMI are warranted.

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