Mortality of Patients with Obstructive Sleep Apnea in Korea

Abstract

Background: Obstructive sleep apnea (OSA) is associated with diverse health risks, including death. However, the role of OSA as a risk factor for death has never been studied in Asians. This study is aimed at evaluating the infl uence of OSA on the mortality in Korean sleep clinic population. Methods: A total of 2,240 patients who underwent in-laboratory full-night polysomnography due to snoring or sleep apnea were included. The patients were categorized based on apnea-hypopnea index (AHI)/hour. Death records were provided from the Statistics Korea. A Cox-proportional hazard regression model and Kaplan-Meier survival curve were used for analysis and demonstration of the all-cause mortality and cardiovascular mortality. Results: The all-cause mortality risk adjusted for age, sex, body mass index, diabetes, hypertension, cardiovascular diseases, and previous history of stroke was signifi cantly associated with the increased severity of OSA. The adjusted hazard ratio (HR) for all-cause mortality in the severe OSA group (AHI ≥ 30) vs. reference group (5 < AHI) was 2.47 (95% confi dence interval [CI], 1.09-5.57) and the adjusted HR for cardiovascular mortality was 4.66 (CI 1.03-21.08). After adjusting for whether the patients were treated or untreated, the HR for all-cause and cardiovascular mortality in the severe OSA group vs. reference group were 2.14 (p = 0.079) and 4.19 (p = 0.076), respectively. Conclusions: The present study showed that the increased mortality was also associated with the increased severity of OSA in Koreans as shown in the studies performed in the Western countries.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia

“…In a study reported by Lee et al, 8 it was found that the morbidity of OSA patients was directly related to its severity. Even though evidence based practices and AASM levels of recommendations advocate that occlusal changes are not always associated with the severity of OSA, extensive diagnostic protocols must be followed including occlusal discrepancies before initiating treatment with oral appliances in order to identify the ideal patient population with risk of complications and associated dental comorbidities.…”

“… 7 Patients suffering from OSA are also reported to have poor quality of sleep, daytime somnolence, cognitive disorders, hypertension, decreased productivity and increased incidence of vehicle accidents. 8 On the other hand obstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of obstructive sleep apneas and hypopneas, which is frequently followed by transient desaturation of blood oxygen levels (hypoxemia) associated with arousal from sleep. 9 According to the American Academy of Sleep Medicine (AASM), the classification of OSA is based on the apnea-hypopnea index (AHI), which is defined by the average number of disordered breathing events per hour of sleep.…”

EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke

“…Five studies explored the association of SDB and incident stroke in the general population [53][54][55][56]. Five studies evaluated prospectively [57][58][59] or retrospectively [60,61] the incidence of stroke or cardiovascular events in patients studied for suspected OSA. Three studies compared cardiovascular outcomes in patients with atrial fibrillation according to presence/absence of OSA [62][63][64].…”

Sex and age differences in the associations between sleep behaviors and all-cause mortality in older adults: results from the National Health and Nutrition Examination Surveys

“…A growing body of evidence has shown that (short or long) sleep duration [1,4–17], sleep disturbances [1,9,18] and obstructive sleep apnea (OSA) [19–26] may predict all-cause [1,9–19,21–25,27–31], cardiovascular- [1,4,10,13,16,17,19,24,29], cancer- [1,16,17,24,30] and dementia-specific [6] mortality rates. Although there are distinct definitions for sleep duration, most studies examining short [1,6,9–11,16 ] or long sleep [5,11,13,15,32] as risk factors for all-cause or cause-specific mortality rates have considered 7–8 h as the optimal range for sleep duration [33–36].…”