Risk of obstructive sleep apnea in patients with bipolar disorder: A nationwide population‐based cohort study in Taiwan

Aim Previous studies have found a high prevalence of risk factors for obstructive sleep apnea (OSA) in patients with bipolar disorder (BD). This study aimed to determine whether BD patients are associated with an increased risk of incident OSA. Methods Using the National Health Insurance Research Da...

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Bibliographic Details
Published in:Psychiatry and clinical neurosciences 2019-04, Vol.73 (4), p.163-168
Main Authors: Chang, En‐Ting, Chen, Shih‐Fen, Chiang, Jen‐Huai, Wang, Ling‐Yi, Hsu, Chung‐Y, Shen, Yu‐Chih
Format: Article
Language:English
Subjects:
Adult
Apnea
Bipolar disorder
Bipolar Disorder - epidemiology
cohort
Cohort analysis
Cohort Studies
Comorbidity
Demography
Female
Humans
Male
Middle Aged
National Health Programs - statistics & numerical data
obstructive sleep apnea
Population studies
Population-based studies
Risk Factors
Sleep
Sleep apnea
Sleep Apnea, Obstructive - epidemiology
Sleep disorders
Taiwan - epidemiology
Young Adult
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Summary:Aim Previous studies have found a high prevalence of risk factors for obstructive sleep apnea (OSA) in patients with bipolar disorder (BD). This study aimed to determine whether BD patients are associated with an increased risk of incident OSA. Methods Using the National Health Insurance Research Database of Taiwan, 3650 BD patients and 18 250 non‐BD controls matched by sex and age were enrolled between 2000 and 2010 and followed until the end of 2013. Patients who developed OSA confirmed by a polysomnographic examination during the follow‐up period were identified. Cox regression analysis was performed to examine the risk of OSA between BD patients and comparative controls. Results BD patients were prone to developing OSA in the crude analysis (hazard ratio [HR]: 1.63, 95% confidence interval [CI]: 1.07–2.49). After adjusting for demographics and comorbidities, the HR declined and was only marginally significant (HR: 1.54, 95%CI: 0.99–2.37). The stratification analysis by sex revealed that the risk trend with BD and subsequent OSA was mainly contributed by male BD patients (HR: 1.72, 95%CI: 1.02–2.91) and female BD patients weakened the overall association. Additionally, this study found that older age, higher income, living in urbanized areas, and some metabolic comorbidities were potential risk factors for developing OSA. Conclusion This study shows that male BD patients are associated with an increased risk of OSA, which has direct implications for the development of targeted prevention interventions or the implementation of a screening algorithm for OSA to reduce its negative health impact.
ISSN:1323-1316
1440-1819
DOI:10.1111/pcn.12802