Format

Send to

Choose Destination
Laryngoscope. 2020 Feb 11. doi: 10.1002/lary.28558. [Epub ahead of print]

Risk of alzheimer's disease in obstructive sleep apnea patients with or without treatment: Real-world evidence.

Tsai MS1,2,3,4, Li HY4,5, Huang CG6,7,8, Wang RYL7, Chuang LP2,4,9, Chen NH4,9, Liu CH2,4,10, Yang YH3,11,12, Liu CY3, Hsu CM1,12, Cheng WN13, Lee LA2,4,5.

Author information

1
Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
2
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
3
Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
4
Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
5
Department of Otolaryngology - Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
6
Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
7
Research Center for Emerging Viral Infections, Chang Gung University, Taoyuan, Taiwan.
8
Graduate Institute of Biomedical Sciences, Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
9
Department of Pulmonary and Critical Care Medicine, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.
10
Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
11
Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
12
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
13
Department of Sports Sciences, University of Taipei, Taipei, Taiwan.

Abstract

OBJECTIVE:

To assess the risk of Alzheimer's disease (AD) in patients with obstructive sleep apnea (OSA) with or without treatment based on real-world evidence.

STUDY DESIGN:

Retrospective cohort study.

METHODS:

Patients newly diagnosed with OSA during 1997-2012 were identified using the National Health Insurance Research Database of Taiwan. Patients without OSA were randomly selected and matched in a 1:4 ratio by age, sex, urbanization level, and income. All patients were followed up until death or the end of 2013. The primary outcome was AD occurrence.

RESULTS:

This study included 3,978 OSA patients and 15,912 non-OSA patients. OSA was independently and significantly associated with a higher incidence of AD in an adjusted Cox proportional hazard model (adjusted hazard ratio: 2.12; 95% confidence interval [CI], 1.27-3.56). The average period of AD detection from the time of OSA occurrence was 5.44 years (standard deviation: 2.96). Subgroup analyses revealed that the effect of OSA remained significant in patients aged ≥60 years, male subgroups, patients without CPAP or surgical treatment, and patients without pharmacological therapies. Patients with OSA who received treatment (continuous positive airway pressure or surgery) exhibited a significantly reduced risk of AD compared with those without treatment (incidence rate ratio 0.23, 95% CI, 0.06-0.98).

CONCLUSION:

OSA is independently associated with an increased risk of AD. Treatment for OSA reduces the AD risk in OSA patients. AD irreversibility renders OSA as a potential modifiable target for slowing or preventing the process of AD development.

LEVEL OF EVIDENCE IV:

Laryngoscope, 2020.

KEYWORDS:

Alzheimer's disease; dementia; obstructive sleep apnea; sleep disturbance; snoring

PMID:
32045010
DOI:
10.1002/lary.28558

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center