Association of psychiatric disorders and sleep apnea in a large cohort

Sleep. 2005 Nov;28(11):1405-11. doi: 10.1093/sleep/28.11.1405.


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.

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Demography
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology*
  • Fatigue / diagnosis
  • Fatigue / epidemiology
  • Female
  • Humans
  • International Classification of Diseases
  • Male
  • Memory Disorders / diagnosis
  • Memory Disorders / epidemiology
  • Middle Aged
  • Prevalence
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / epidemiology*
  • Quality of Life / psychology
  • Retrospective Studies
  • Severity of Illness Index
  • Sleep Apnea Syndromes / epidemiology*
  • Sleep Deprivation / epidemiology
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Veterans / statistics & numerical data