Abstract

OBJECTIVE
Obstructive sleep apnea syndrome (OSAS) is a pervasive problem that affects millions worldwide. It is strongly linked to hypertension, coronary artery disease, and stroke. However, its association with mortality is not clearly quantified. A large database of patients who underwent sleep testing was explored for associations with all-cause mortality.
STUDY DESIGN
Database study.
SETTING
Community-based use of a portable sleep study device.
SUBJECTS AND METHODS
More than 77,000 patients who underwent a validated, portable sleep study were matched to the Social Security Death File to establish mortality. Measures of OSAS severity and other confounding factors were correlated to all-cause mortality using survival analysis with multivariate Cox proportional hazards regression.
RESULTS
As expected, increasing age (adjusted hazard ratio [HR], 1.080; 95% confidence interval [CI], 1.074-1.086; P < .0001), body mass index (HR, 1.042; 95% CI, 1.033-1.051; P < .0001), and male sex (HR, 1.378; 95% CI, 1.190-1.595; P < .001) were associated with increased all-cause mortality. Epworth sleepiness score was also associated with mortality (HR, 1.015; 95% CI, 1.005-1.025; P = .002). Apnea-hypopnea index (AHI) was not associated with mortality after adjustment for age (HR, 1.001; 95% CI, 0.998-1.004; P = .416). However, within 10-year age subgroups, desaturation index (ages 41-50 years; adjusted HR, 1.217; 95% CI, 1.014-1.461; P = .035), apnea index (ages 21-30 years; HR, 1.632; 95% CI, 1.053-2.532; P = .028), and AHI (ages 31-40 years; HR, 1.222; 95% CI, 1.010-1.478; P = .039) were significantly associated with all-cause mortality in younger patients. In patients older than 50 years, age, sex, and body mass index were dominantly associated with mortality.
CONCLUSION
Increasing OSAS severity, measured by a validated home sleep test and quantified by AHI, the apnea index, and the desaturation index, is independently associated with modestly increased all-cause mortality in patients younger than 50 years after adjustment for major confounding factors.

Links

Publisher Full Text

Authors

Rich J, Raviv A, Raviv N, Brietzke SE

Institution

Department of Otolaryngology, Walter Reed National Military Medical Center, Bethesda, Maryland 20889, USA.

Source

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 147:3 2012 Sep pg 583-7

MeSH

Adult
Age Factors
Aged
Analysis of Variance
Body Mass Index
Cause of Death
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Polysomnography
Proportional Hazards Models
Risk Factors
Sex Factors
Sleep Apnea, Obstructive
Young Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22687326