A 30-year-old man presenting with intellectual impairment and recurrent psychotic episodes was subsequently found to have suffered from a chronically untreated obstructive sleep apnoea syndrome. Polysomnography revealed sleep fragmentation, slow wave sleep deprivation and abnormal arterial oxygen desaturation. Tonsillectomy led to complete resolution of sleep apnoea and remission of psychosis at 2 years' follow-up, but his apparent intellectual impairment persisted. The limited literature on psychosis associated with sleep apnoea is briefly reviewed.
References
1.
BlazerD. Hypersomnia in manic-depressive illness: a case of sleep apnoea. North Carolina Medical Journal1981; 42: 781–782
2.
HaponikEFSmithPLMeyersDABleeckerER. Evaluation of sleep-disordered breathing — Is polysomnography necessary?American Journal of Medicine1984; 77: 671–677
3.
GuilleminaultCDementW. Sleep apnoea syndromes and related sleep disorders. In: WilliamsRLKaracanI eds. Sleep Disorders: Diagnosis and Treatment. New York: John Wiley and Sons1978:9–28
4.
CarskadonMA. Guidelines for the multiple sleep latency test (MSLT): A standard measure of sleepiness. Sleep1986; 9: 519–524
5.
GreenbergGDWatsonRKDeptulaD. Neuropsychological dysfunction in sleep apnoea. Sleep1987; 10: 254–262
6.
BerrettiniWH. Paranoid psychosis and sleep apnoea syndrome. American Journal of Psychiatry1980; 137: 493–494
7.
MartinPRLefebvreAM. Surgical treatment of sleep-apnoea-associated psychosis. Canadian Medical Association Journal1981; 124: 978–980
8.
FlemingJAEFleeihamJATaylorDRRemickRA. A case report of obstructive sleep apnoea in a patient with bipolar affective disorder. Canadian Journal of Psychiatry1985; 30: 437–439
9.
WylerARWeymullerEA. Epilepsy complicated by sleep apnoea. Annals of Neurology1980; 9: 403–404
10.
SobelSVFainmanCKripkeDF. Effect of haloperidol on sleep apnoea. American Journal of Psychiatry1985; 142: 775–776
11.
RoyA. Psychiatric aspects of narcolepsy. British Journal of Psychiatry1976; 128: 562–565
12.
GuilleminaultCEldridgeFLSimmonsFBDementW. Sleep apnoea in eight children. Pediatrics1976; 58: 23–31
13.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders1987 (3rd ed., revised) (DSM III-R), Washington, DC: APA
14.
WestLJ. Psychopathology produced by sleep deprivation. In: KetySSEvartsEVWilliamsHL eds. Sleep and Altered States of Consciousness. Baltimore: Williams and Wilkins1967:535–558
15.
McNamaraMESouthwickSMFogelBS. Sleep apnoea and hypothyroidism presenting as depression in two patients. Journal of Clinical Psychiatry1987; 48: 164–165