Mortality in severe sleep apnoea/hypopnoea syndrome patients: impact of treatment

Abstract

The aim of this study was to determine mortality in patients with sleep apnoea/hypopnoea syndrome (SAHS) according to the treatments employed and comorbidity.An historical cohort of patients with SAHS diagnosed at a university hospital between 1982 and 1992 and followed until 1996 was studied. From a total of 475 SAHS patients, 444 (94%), with a mean±sd apnoea/hypopnoea index at diagnosis of 55±27, were located and included in the study. SAHS treatments employed were: surgery (88), weight loss (134), continuous positive airway pressure (124) and 98 patients were not treated.By the end of follow-up, 49 patients had died. According to Cox regression analysis, mortality in treated patients was lower than in those not treated, but higher in those with a history of severe chronic obstructive pulmonary disease. Mortality in nontreated patients compared with that of the general population, adjusted for age and sex, showed excessive mortality, which decreased in treated patients. Stratification by age showed a greater mortality rate ratio in patients <50 yrs. These findings were maintained when mortality from cardiovascular causes was compared.In conclusion, a rise in mortality was found in nontreated sleep apnoea/hypopnoea syndrome patients compared with the general population, whereas mortality in those treated for sleep apnoea/hypopnoea syndrome did not differ significantly from that of the general population.

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

“…Thus, mortality hazard ratios associated with the RDI categories 11-30 that only bordered on statistical significance would possibly move toward 1.0 after adjustment for additional relevant risk factors. Previous sleep apnoea mortality studies in which adjustment to confounders, such as medical condition at diagnosis, was carried out did not find any association between mortality and the severity of the syndrome [15,16]. Since the current authors did not have reliable data on treatment outcomes, the influence of treatment on mortality was also not examined.…”

“…Although there have been reports of increased rates of mortality in sleep apnoea patients [14][15][16], these reports, based on small groups, did not examine the contributing role of obesity, nor the relationship with the severity of sleep apnoea syndrome. In this investigation, these questions were addressed by conducting a follow-up mortality study in a large cohort of males clinically evaluated by polysomnography because of suspected sleep apnoea syndrome.…”

Surgical Therapy of Obstructive Sleep Apnea: A Review

“…Marti et al [67] followed a cohort of 444 patients, between the years 1982 and 1996. The cohort consisted of normals (no OSA) and those with OSA.…”

Obstructive sleep apnea syndrome - diagnostics

“…Patienten mit schwerem OSAS haben jedoch durch die begleitenden Risikofaktoren ein deutlich gesteigertes Mortalitäts-risiko. Es konnte gezeigt werden, dass eine CPAP (continuous positive airway pressure)-Therapie dieses Risiko zu senken vermag (23).…”