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Mortality risk factors in sleep apnoea: a matched case–control study
Author(s) -
LAVIE PERETZ,
HERER PAULA,
LAVIE LENA
Publication year - 2007
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/j.1365-2869.2007.00578.x
Subject(s) - medicine , polysomnography , copd , body mass index , odds ratio , obesity , diabetes mellitus , cohort , cohort study , population , heart failure , pediatrics , apnea , endocrinology , environmental health
Summary Sleep apnoea syndrome was reported to be associated with increased mortality but it is not known if this association is independent of obesity and co‐morbidities. The present study investigated predictors of mortality in a large cohort of men with sleep apnoea using a case–control design. The study population consisted of 10 981 men diagnosed during 1991–2000 by whole‐night polysomnography with sleep apnoea; 331 men died prior to 1 September 2001, of whom 277 were matched by age, gender, site and time of study to patients who were alive in September 2001. Multivariate analysis revealed that all‐cause mortality was associated with chronic obstructive pulmonary disease (COPD) (odds ratio, OR: 7.07, 95% CI 2.75–18.16), chronic heart failure (CHF) (OR: 5.47, 95% CI 1.06–28.31), diabetes mellitus (DM) (OR: 3.30, 95% CI 1.51–7.20) and body mass index (BMI) (increase of 5 kg m −2 , OR: 1.44, 95% CI: 1.04–1.99). Chronic upper airway problems were associated with survival (OR: 0.45, 95% CI 0.23–0.90). There were significant interactions between respiratory disturbance index and BMI and COPD. Mortality of patients younger than the median age (62 years) was associated with COPD, DM and an interaction between BMI and apnoea severity. Predictors of mortality for the older patients were COPD, CHF and DM. We conclude that all‐cause mortality in sleep apnoea is associated with co‐morbidities and obesity. Severity of sleep apnoea affects mortality by interacting with obesity and lung disease.