All-cause mortality in males with sleep apnoea syndrome: declining mortality rates with age

Abstract

The objective of this study was to assess whether an increasing severity of sleep apnoea is associated with increased all-cause mortality hazards and to assess whether the syndrome is associated with excess mortality, in comparison with the general population.Participants included 14,589 adult males, aged 20-93 yrs, referred to the sleep clinics with suspected sleep apnoea or diagnosed with sleep apnoea.Altogether, 372 deaths were recorded after a median follow-up of 4.6 yrs. The crude all-cause mortality rate was 5.55/1,000 patient yrs, increasing with apnoea severity. Cox proportional analysis revealed that both respiratory disturbance index (RDI) and body mass index significantly influenced all-cause mortality hazard but there was no interaction between them. Males with respiratory disturbance index .30 had a significantly higher mortality hazard rate than the reference group of males with RDI f10. Comparing mortality rates of males with moderate/severe sleep apnoea to the general population revealed that only males aged ,50 yrs showed an excess mortality rate.The hazard of mortality in sleep apnoea increases with apnoea severity as indexed by respiratory disturbance index. Moderate and severe levels of sleep apnoea are moderately associated with an increased risk of all-cause mortality, in comparison with the general population, particularly in males aged ,50 yrs. The lack of information about possible confounders and treatment effects should be taken into consideration in the interpretation of these results.

Sleep Apnea and Cardiovascular Disease

“…62 This concept has found support in more recent data showing that younger people with OSA may be more likely to have hypertension 65 and atrial fibrillation 66 and to suffer greater all-cause mortality. 67 These data may argue in favor of a more aggressive diagnostic and therapeutic strategy in younger and middle-aged subjects with OSA. Differential effects of race, gender, and other demographics also merit consideration and require further investigation.…”

Intermittent hypoxia-induced delayed cardioprotection is mediated by PKC and triggered by p38 MAP kinase and Erk1/2

“…It has been extensively demonstrated both in animals [3] and humans [4] that IH is a determinant of cardiovascular morbidity. Surprisingly, a decline in mortality rates with age has been observed in OSA patients [5], which suggests a possible cardiovascular protection by IH [6]. There are several described differences between sustained hypoxia (SH) and IH.…”

All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment: A registry study with 10 years of follow-up

“…OSA increases the risk of cardiovascular and cerebrovascular (CVD) morbidity and mortality, 1 and has been recognized as a source of attributable risk in patients with hypertension, obesity, diabetes, cardiovascular diseases, and stroke, [2][3][4][5][6][7] although some studies were negative. [8][9][10][11][12] However, we have almost no data from more unselected patient cohorts with OSA.…”