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Research ArticleOriginal Research

Sleep Apnea and Risk of Panic Disorder

Vincent Yi-Fong Su, Yung-Tai Chen, Wei-Chen Lin, Li-An Wu, Shi-Chuan Chang, Diahn-Warng Perng, Wei-Juin Su, Yuh-Min Chen, Tzeng-Ji Chen, Yu-Chin Lee and Kun-Ta Chou
The Annals of Family Medicine July 2015, 13 (4) 325-330; DOI: https://doi.org/10.1370/afm.1815
Vincent Yi-Fong Su
1Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
9Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Yung-Tai Chen
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
4Department of Medicine, Heping-Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
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Wei-Chen Lin
1Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
5Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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Li-An Wu
6Department of Radiology, Heping-Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
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Shi-Chuan Chang
1Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
7Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Diahn-Warng Perng
1Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Wei-Juin Su
2Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Yuh-Min Chen
2Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Tzeng-Ji Chen
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
8Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Yu-Chin Lee
2Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
9Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Kun-Ta Chou
1Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
3School of Medicine, National Yang-Ming University, Taipei, Taiwan
9Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • For correspondence: ale1371@yahoo.com.tw
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Abstract

PURPOSE Epidemiological studies have identified a trend in the development of depressive and anxiety disorders following a diagnosis of sleep apnea. The relationship between sleep apnea and subsequent panic disorder, however, remains unclear.

METHODS Using a nationwide database, the Taiwan National Health Insurance Research Database, patients with sleep apnea and age-, sex-, income-, and urbanization-matched control patients who did not have sleep apnea were enrolled between 2000 and 2010. Patients with a prior diagnosis of panic disorder before enrollment were excluded. The 2 cohorts were observed until December 31, 2010. The primary endpoint was occurrence of newly diagnosed panic disorder.

RESULTS A total of 8,704 sleep apnea patients and 34,792 control patients were enrolled. Of the 43,496 patients, 263 (0.60%) suffered from panic disorder during a mean follow-up period of 3.92 years, including 117 (1.34%) from the sleep apnea cohort and 146 (0.42%) from the control group. The Kaplan-Meier analysis revealed a predisposition of patients with sleep apnea to develop panic disorder (log-rank test, P <.001). After multivariate adjustment, the hazard ratio for subsequent panic disorder among the sleep apnea patients was 2.17 (95% confidence interval, 1.68–2.81; P <.001).

CONCLUSIONS Sleep apnea appears to confer a higher risk for future development of panic disorder.

  • sleep apnea syndromes
  • sleep-disordered breathing
  • panic disorder
  • Received for publication November 19, 2014.
  • Revision received November 22, 2015.
  • Accepted for publication May 22, 2015.
  • © 2015 Annals of Family Medicine, Inc.
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Sleep Apnea and Risk of Panic Disorder
Vincent Yi-Fong Su, Yung-Tai Chen, Wei-Chen Lin, Li-An Wu, Shi-Chuan Chang, Diahn-Warng Perng, Wei-Juin Su, Yuh-Min Chen, Tzeng-Ji Chen, Yu-Chin Lee, Kun-Ta Chou
The Annals of Family Medicine Jul 2015, 13 (4) 325-330; DOI: 10.1370/afm.1815

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Sleep Apnea and Risk of Panic Disorder
Vincent Yi-Fong Su, Yung-Tai Chen, Wei-Chen Lin, Li-An Wu, Shi-Chuan Chang, Diahn-Warng Perng, Wei-Juin Su, Yuh-Min Chen, Tzeng-Ji Chen, Yu-Chin Lee, Kun-Ta Chou
The Annals of Family Medicine Jul 2015, 13 (4) 325-330; DOI: 10.1370/afm.1815
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