OSA Treatment on Cardio‐ and Cerebrovascular Comorbidities: A Long‐term Nationwide Cohort Study

Abstract

Objective To compare the cardio- and cerebrovascular outcomes and survival rates of surgical and nonsurgical interventions for patients with obstructive sleep apnea (OSA) based on a national population-based database. Study Design Retrospective cohort study. Setting Taiwan National Health Insurance Research Database. Methods We analyzed all cases of OSA among adults (age >20 years and confirmed with ICD-9-CM) from January 2001 to December 2013. We compared the patients with OSA who received upper airway surgery with age-, sex-, and comorbidity index–matched controls with continuous positive airway pressure (CPAP) treatment. The risk of myocardial infarction (MI) or stroke after treatment of OSA-related surgery versus CPAP was investigated. Results During follow-up, 112 and 92 incident cases of MI occurred in the OSA surgery and CPAP treatment groups, respectively (rates of 327 and 298 per 100,000 person-years). Furthermore, 50 and 39 cases were newly diagnosed with stroke in the OSA surgery and CPAP treatment groups (rates of 144 and 125 per 100,000 person-years). Cox proportional hazard regressions showed that the OSA treatment groups (OSA surgery vs CPAP) were not significantly related to MI (hazard ratio, 1.03 [95% CI, 0.781-1.359]; P = .833) and stroke (hazard ratio, 1.12 [95% CI, 0.736-1.706]; P = .596) at follow-up, after adjustment for sex, age at index date, days from diagnosis to treatment, and comorbidities. Conclusion Our study demonstrated that there was no difference of cardio- and cerebrovascular results between CPAP and surgery for patients with OSA in a 13-year follow-up. Level of Evidence 3.

Minimally invasive, single‐stage, multilevel surgery for obstructive sleep apnoea: A systematic review and meta‐analysis

“…It remains unclear whether a longer follow‐up period may generate different outcomes. Third, it is essential for evaluating the value of any OSA treatment via investigating the cardio‐ and cerebrovascular outcomes of the patients 31,32 . Thus, further MISS MLS studies for patients with OSA in this field should be conducted.…”

“…Third, it is essential for evaluating the value of any OSA treatment via investigating the cardio-and cerebrovascular outcomes of the patients. 31,32 Thus, further MISS MLS studies for patients with OSA in this field should be conducted. Finally, no restrictions on the publish date were set.…”

Analysis of Internet‐Based Written Materials on Surgery for Obstructive Sleep Apnea

“…Sleep surgery is an effective alternative treatment for OSA, with improved cardiovascular and cerebrovascular outcomes compared to no treatment. 5 , 6 Previous studies with focus groups have found that patients with OSA desire more information about CPAP‐alternative treatment options from their providers. 7 …”

“…Sleep surgery is an effective alternative treatment for OSA, with improved cardiovascular and cerebrovascular outcomes compared to no treatment. 5,6 Previous studies with focus groups have found that patients with OSA desire more information about CPAP-alternative treatment options from their providers. 7 Despite the internet being an important source of information for patients who are researching sleep surgery, there is a dearth of information regarding the quality of the online materials available for patients interested OSA surgery.…”

“…Adult sleep surgery encompasses a variety of procedures including nasal surgery, soft tissue procedures including palatine tonsillectomy, uvulopalatopharyngoplasty, lingual tonsillectomy, tongue reduction, radiofrequency ablation, and hyoid suspension, hypoglossal nerve stimulator implantation, and maxillomandibular advancement surgery. Sleep surgery is an effective alternative treatment for OSA, with improved cardiovascular and cerebrovascular outcomes compared to no treatment 5,6 . Previous studies with focus groups have found that patients with OSA desire more information about CPAP‐alternative treatment options from their providers 7 …”