Obstructive sleep apnea from a psychiatric viewpoint

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with a lifetime prevalence of 2–14% in theadult population. The hallmark of the disease are recurrent apneic episodes caused by a closure of the upper airways at the endof expiration. The most common cause of the closure is the accumulation of fat tissue around the pharynx and the soft palate.Apneic episodes lead to activation of the sympathetic nervous system, fragmentation of sleep, and its inadequate quality. Diagnostictests are performed in sleep laboratories, and treatment consists in lifestyle measures, weight reduction, and in deliveringoverpressure in the airways with a continuous positive airway pressure (CPAP) device coupled with a facial mask. In the literature,OSA is discussed as a very common comorbidity of affective and cognitive disorders which, when unrecognized, may worsen thesymptoms of an underlying psychiatric illness and prevent from achieving remission. The article summarizes the basic mechanismsof the development of sleep apnea, its risk factors, symptoms, and treatment as well as its effect on the symptoms and treatmentof affective disorders and cognitive function disorders.

Keywords: sleep, apnea, depression, cognitive, functions