Metabolic syndrome among patients taking second generation antipsychotics: does obstructive sleep apnoea and sleep quality play any role?

Background: Metabolic syndrome (MetS) is common among patients who have been exposed to second generation antipsychotics (SGA). Obstructive sleep apnoea (OSA) and sleep quality may also contribute to MetS. Aims: To study the contribution of sleep quality and OSA on the development of MetS in patients taking SGA. Methods: Total 60 patients taking SGA for more than three months were taken for the study. It was an observational, cross-sectional study. The diagnosis of OSA was done using Hindi translation of Berlin questionnaire. Hindi version of the Pittsburg Sleep Quality Index was used to assess the sleep quality. MetS was diagnosed using Adult Treatment Panel III criteria. Results: Forty two subjects did not have MetS, out of which 35 had low risk of OSA and seven had high risk of OSA, while 18 subjects had MetS of which nine each had high and low risk of OSA. The results were highly significant with a p-value of 0.007 (p≤0.05). Subjects without MetS (n=42) comprised four good sleepers and 38 poor sleepers. Subjects with MetS (n=18) comprised of one good sleeper and 17 poor sleepers. The results were non-significant with a p-value of 0.525 (p≥0.05). The high risk of OSA had around seven times higher likelihood of contribution to MetS. Conclusions: Sleep quality did not play a significant role in increasing the likelihood of MetS and OSA increased the likelihood of MetS in subjects exposed to SGA by seven times.