A negative effect by ATC N-class treatment in OSA patients with concomitant psychiatric disease: an ESADA cohort study.

A high prevalence of OSA has been reported in patients with major psychiatric diseases (PSY). However, the effect of PSY treatment on OSA severity and symptoms is not known. We analyzed from the ESADA cohort the data of 2832 OSA with concomitant PSY. (F 47.9%; age 51.4 ± 12,3 years; BMI 32±7,2 Kg/m2, ESS 9,8±5,6, AHI 26,4±26,8, ODI 22,7±25,7). 72.6% of patients were on treatment with ATC N-Class medications: 8.1% with anti-epilepsy drugs, 29.1% with psycholeptics, 47.3% with psycho-analeptics and 9.9% with other nervous system drugs. We found a higher EPWORTH score in PSY patients and a more severe OSA (table 1). In particular, prescription of anti-epilepsy drugs was associated with more severe nocturnal hypoxemia (ODI 26.9±30.2 vs 22.3±25.2, p 0.01) while psycho-analeptics prescription with higher ESS score (10.3±5.3 vs 9.3± 5.8, p<0.001). We found in this large study that concomitant ATC N-class medication is associated with worse OSA severity that is independent of BMI. <table-wrap><object-id>erj;64/suppl_68/PA2678/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>No prescription<break></break>(n=776)</td><td>All N-class prescription<break></break>(n=2056)</td><td>Total</td><td>p</td></tr><tr><td>AGE (yrs)</td><td>51.9±13.3</td><td>51,1±11.9</td><td>51.3±12.3</td><td>n.s</td></tr><tr><td>BMI (kg/m2)</td><td>31.5 ±7.3</td><td>32.1±7.2</td><td>32±7,2</td><td>0.055</td></tr><tr><td>ESS</td><td>9±5.9</td><td>10.1±5.4</td><td>9.8±5.4</td><td><0.0001</td></tr><tr><td>AHI (ev*hr-1)</td><td>23.7±25.2</td><td>27.6±27.2</td><td>26.5±26.8</td><td><0.0001</td></tr><tr><td>ODI ev*(hr-1)</td><td>20.2±24.3</td><td>23.6±26.2</td><td>22.7±26.2</td><td>0,002</td></tr></tbody></table></table-wrap>