Association of psychiatric disorders and sleep apnea in a large cohort

Sharafkhaneh, Amir; Giray, Nilgun; Richardson, Peter; Young, Terry; Hirshkowitz, Max

doi:10.1093/sleep/28.11.1405

Cited by 454Obstructive Sleep Apnea ResearchSleep and related disordersTemporomandibular Joint Disorders

Association of psychiatric disorders and sleep apnea in a large cohort

Sharafkhaneh, Amir, Giray, Nilgun, Richardson, Peter, Young, Terry, Hirshkowitz, Max·2005·SLEEP

DOI 10.1093/sleep/28.11.1405

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Abstract

STUDY OBJECTIVES: We conducted the present study to determine whether psychiatric disorders are commonly associated with sleep apnea in Veterans Health Administration beneficiaries. METHOD: The Veterans Health Administration maintains several centralized databases containing healthcare data for more than 4 million veterans. We reviewed data from 1998 to 2001 and identified patient records having International Classification of Diseases-Ninth Edition-Clinical Modification codes indicating sleep apnea and various psychiatric conditions. Subsequently, we compared age, sex, ethnicity, and prevalence of comorbid psychiatric conditions for Veterans Health Administration beneficiaries with and without sleep apnea. RESULTS: Out of 4,060,504 unique cases, 118,105 were identified as having sleep apnea (estimated prevalence of 2.91%). Mean age at the time of diagnosis was 57.6 years. Psychiatric comorbid diagnoses in the sleep apnea group included depression (21.8%), anxiety (16.7%), posttraumatic stress disorder (11.9%), psychosis (5.1), and bipolar disorders (3.3%). Compared with patients not diagnosed with sleep apnea, a significantly greater prevalence (P < .0001) was found for mood disorders, anxiety, posttraumatic stress disorder, psychosis, and dementia in patients with sleep apnea. CONCLUSIONS: Sleep apnea is associated with a higher prevalence of psychiatric comorbid conditions in Veterans Health Administration beneficiaries. This association suggests that patients with psychiatric disorders and coincident symptoms suggesting sleep-disordered breathing should be evaluated for sleep apnea.

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Rates of sleep apnoea appear elevated in individuals with schizophrenia, with around 15% of patients exhibiting clinically significant symptoms.
“Rates of sleep apnoea also appear elevated in individuals with schizophrenia — around 15% of patients have been found to exhibit clinically significant symptoms (Sharafkhaneh, Giray, Richardson, Young, & Hirshkowitz, 2005).”
From The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review (2015) · cites this paper as Sharafkhaneh, Giray, Richardson, Young, & Hirshkowitz, 2005
Specific sleep disorders, such as sleep apnoea, circadian rhythm disruption, restless leg syndrome, excessive daytime sleepiness and narcolepsy, sleepwalking, and nightmares, are all more prevalent in those experiencing mental health difficulties.
“Studies have also found that specific sleep disorders, such as sleep apnoea [28], circadian rhythm disruption [29], restless leg syndrome [30], excessive daytime sleepiness and narcolepsy [31,32], sleepwalking [33], and nightmares [34] are all more prevalent in those experiencing mental health difficulties.”
From Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials (2021) · cites this paper as [28]

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Authors: Sharafkhaneh, A., Giray, N., Richardson, P., Young, T., & Hirshkowitz, M.
Affiliations: Michael E. DeBakey VA Medical Center (US)
Baylor College of Medicine (US)
University of Wisconsin–Madison (US)
Corresponding author: Sharafkhaneh, Amir
ORCID: Sharafkhaneh, Amir
Hirshkowitz, Max
Venue: SLEEP
Publisher: Oxford University Press (OUP)
Published: 2005-11
Volume: 28
Issue: 11
Pages: 1405-1411
ISSN: 0161-8105 (ISSN-L)
1550-9109
DOI: 10.1093/sleep/28.11.1405
OpenAlex: W2187052164
Cited by: 454
References: 51
Citations by year: 2026: 10 · 2025: 14 · 2024: 20 · 2023: 26 · 2022: 17 · 2021: 30 · 2020: 26 · 2019: 30 · 2018: 31 · 2017: 36 · 2016: 26 · 2015: 31 · 2014: 19 · 2013: 25 · 2012: 23
FWCI: 8.42
Type: journal article
Language: en
Open access: closed
Locations: SLEEP (publishedVersion)
PubMed (publishedVersion)
Funders: Pfizer
Sanofi
ResMed
H. Lundbeck A/S
Topics: Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
Keywords: sleep apnea, psychiatric comorbidity, depression, anxiety, post-traumatic stress disorder, psychosis, bipolar disorder, dementia, mood disorders, veterans, sleep-disordered breathing, prevalence
MeSH terms: Adult, Aged, Anxiety Disorders, Bipolar Disorder, Cardiovascular Diseases, Cross-Sectional Studies, Demography, Depressive Disorder, Major, Major Depressive Disorder, Fatigue, Female, Humans, Male, Memory Disorders, Middle Aged, Psychotic Disorders, Quality of Life, Retrospective Studies, Severity of Illness Index, Sleep Apnea Syndromes, Sleep Deprivation, Stress Disorders, Post-Traumatic, Veterans, Cohort Studies, Prevalence, International Classification of Diseases

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Association of psychiatric disorders and sleep apnea in a large cohort

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