睡眠呼吸暂停患者患耳鸣的风险：一项基于全国人口的病例对照研究。

Risk of tinnitus in patients with sleep apnea: A nationwide, population-based, case-control study.

作者信息

Koo Malcolm, Hwang Juen-Haur

机构信息

Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.

出版信息

Laryngoscope. 2017 Sep;127(9):2171-2175. doi: 10.1002/lary.26323. Epub 2016 Sep 26.

DOI:10.1002/lary.26323

PMID:27666578

Abstract

OBJECTIVE

To investigate the risk of tinnitus in patients with sleep disturbance or sleep apnea.

STUDY DESIGN

Case control study.

METHODS

We identified 21,798 middle-aged and elderly patients with otolaryngologist-diagnosed tinnitus between January 1, 2000, and December 31, 2012, from the Longitudinal Health Insurance Database 2000 of the Taiwan National Health Insurance Research Database. A total of 108,990 controls were also identified from the same database based on frequency-matching on 10-year age interval, sex, and year of index date of the cases. Diagnoses of sleep disturbance (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] codes 780.50, 780.52, 307.4) and sleep apnea (ICD-9-CM codes 780.51, 780.53, 780.57) in the cases and controls prior to the index date were assessed. The risks of tinnitus in patients with sleep disturbance and sleep apnea were separately evaluated with multivariate logistic regression analyses.

RESULTS

The mean age of the total 130,788 patients was 59.8 years, and 47% of them were males. The risk of tinnitus was higher in patients with sleep disturbance compared to those without the condition (adjusted odds ratio [OR] = 1.13, 95% confidence interval [CI] [95% CI] = 1.11-1.17), and the risk of tinnitus was higher in patients with sleep apnea compared to those without the condition (adjusted OR = 1.36, 95% CI = 1.16-1.60).

CONCLUSION

In this population-based, case-control study, the risk of tinnitus was found to be significantly higher among middle-aged and elderly Taiwanese patients with sleep disturbances, especially with sleep apnea.

LEVEL OF EVIDENCE

3b. Laryngoscope, 127:2171-2175, 2017.

摘要

目的

探讨睡眠障碍或睡眠呼吸暂停患者发生耳鸣的风险。

研究设计

病例对照研究。

方法

我们从台湾国民健康保险研究数据库2000纵向健康保险数据库中，识别出2000年1月1日至2012年12月31日期间，经耳鼻喉科医生诊断为耳鸣的21,798名中老年患者。基于病例的10岁年龄区间、性别和索引日期年份进行频率匹配，从同一数据库中总共识别出108,990名对照。评估病例和对照在索引日期之前的睡眠障碍（国际疾病分类，第9版，临床修订版[ICD-9-CM]编码780.50、780.52、307.4）和睡眠呼吸暂停（ICD-9-CM编码780.51、780.53、780.57）诊断情况。采用多因素逻辑回归分析分别评估睡眠障碍和睡眠呼吸暂停患者发生耳鸣的风险。

结果

130,788名患者的平均年龄为59.8岁，其中47%为男性。与无睡眠障碍的患者相比，睡眠障碍患者发生耳鸣的风险更高（调整优势比[OR]=1.13，95%置信区间[CI][95%CI]=1.11 - 1.17）；与无睡眠呼吸暂停的患者相比，睡眠呼吸暂停患者发生耳鸣的风险更高（调整OR = 1.36，95%CI = 1.16 - 1.60）。