CPAP‐induced mania in bipolar disorder: a case report

Objective In this case report we present our clinical observations of two patients with bipolar disorder with comorbid obstructive sleep apnea (OSA) who were treated with continuous positive airway pressure (CPAP) for their sleep apnea. Background Bipolar disorder is a psychiatric disorder character...

Full description

Saved in:
Bibliographic Details
Published in:Bipolar disorders 2013-11, Vol.15 (7), p.803-807
Main Authors: Aggarwal, Richa, Baweja, Raman, Saunders, Erika FH, Singareddy, Ravi
Format: Article
Language:English
Subjects:
bipolar disorder
Bipolar Disorder - complications
Bipolar Disorder - etiology
continuous positive airway pressure
Continuous Positive Airway Pressure - adverse effects
CPAP
Humans
Male
Middle Aged
obstructive sleep apnea
OSA
Sleep Apnea, Obstructive - complications
Sleep Apnea, Obstructive - therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective In this case report we present our clinical observations of two patients with bipolar disorder with comorbid obstructive sleep apnea (OSA) who were treated with continuous positive airway pressure (CPAP) for their sleep apnea. Background Bipolar disorder is a psychiatric disorder characterized by the presence of one or more episodes of mania and frequent episodes of depression. This disorder affects approximately 0.8% of the adult population, with estimates from community samples ranging between 0.4% and 1.6%. OSA syndrome is a severe sleep disorder with a prevalence of 2–4% in the general population, the risk of which is increased by obesity. The prevalence of OSA is expected to be high in bipolar disorder due to high comorbid obesity. It is expected that improvement in OSA in patients with bipolar disorder with CPAP will improve mood and other symptoms of bipolar disorder. However, there is a relative lack of data examining this aspect. Results In both cases of bipolar disorder, CPAP was started after a polysomnographic diagnosis of OSA and CPAP titration study indicating that most of the apneas/hypopneas were eliminated with a significant improvement in oxygen saturation. To our surprise, we noted that in both of these cases initiation of CPAP resulted in manic symptoms. Conclusions Clinicians need to monitor patients with bipolar disorder closely for worsening of manic symptoms when they are started on CPAP for underlying OSA.
ISSN:1398-5647
1399-5618
DOI:10.1111/bdi.12112