思覺失調症與阻塞型睡眠呼吸中止症的共病

The Comorbidity of Schizophrenia and Obstructive Sleep Apnea

阻塞型睡眠呼吸中止症（obstructive sleep apnea, OSA）是一種常見且影響深遠的睡眠障礙，過去研究多聚焦於心血管與代謝疾病。然而，近年證據顯示，OSA與心理健康問題密切相關，包括憂鬱、焦慮與認知功能受損。本文從精神科護理視角，敘述性回顧思覺失調症患者中OSA的盛行率、危險因子、病理機轉與臨床影響，並探討診斷與治療上的挑戰。研究結果顯示，思覺失調症患者的OSA盛行率明顯高於一般人口，但診斷率與治療率卻偏低。OSA不僅惡化認知與情緒狀態，還增加心血管與代謝風險，並削弱治療依從性與生活品質。精神科護理師在健康教育、症狀監測、依從性支持及跨專業合作中扮演關鍵角色。未來研究應驗證護理介入與數位健康方案的成效，並探索人工智慧與遠距醫療於OSA心理照護中的應用，以提升患者生活品質與長期預後。

Obstructive sleep apnea (OSA) is a common and clinically significant sleep disorder traditionally been studied in relation to cardiovascular and metabolic diseases. Increasing evidence, however, underscores its strong association with mental health problems, including depression, anxiety, and cognitive impairment. From a psychiatric nursing perspective, this narrative review synthesizes current evidence on the prevalence, risk factors, pathophysiological mechanisms, and clinical implications of OSA in individuals with schizophrenia, while addressing diagnostic and therapeutic challenges. Findings indicate that the prevalence of OSA is substantially higher among people with schizophrenia than in the general population, yet diagnosis and treatment rates remain disproportionately low. OSA not only exacerbates cognitive and emotional dysfunction, but also increases cardiometabolic risks, undermines treatment adherence, and reduces quality of life. Psychiatric nurses play a pivotal role in health education, symptom monitoring, adherence support, and interdisciplinary collaboration. Future research should evaluate the effectiveness of nursing-led and digital health interventions, and explore the application of artificial intelligence and telemedicine in the management of OSA to enhance patients' quality of life and long-term outcomes.