Tsai Ming-Shao, Lee Li-Ang, Tsai Yao-Te, Yang Yao-Hsu, Liu Chia-Yen, Lin Meng-Hung, Hsu Cheng-Ming, Chen Chin-Kuo, Li Hsueh-Yu
Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, Republic of China.
Center of Excellence for Chang Gung Research Datalink, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, Republic of China.
Laryngoscope. 2018 Mar;128(3):763-768. doi: 10.1002/lary.26789. Epub 2017 Aug 3.
To investigate the risk of vertigo in patients with sleep apnea.
Retrospective cohort study.
This study used data from the National Health Insurance Research Database of Taiwan, a population-based database. A total of 5,025 patients who were newly diagnosed with sleep apnea between January 1, 1997, and December 31, 2012, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 20,100 patients without sleep apnea were matched at a 1:4 ratio by age, sex, socioeconomic status, and urbanization level. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of vertigo.
Patients with sleep apnea had a significantly higher cumulative incidence of vertigo than those without sleep apnea (P < 0.001). The adjusted Cox proportional hazard model showed that sleep apnea was significantly associated with a higher incidence of vertigo (hazard ratio, 1.71; 95% confidence interval [CI], 1.48-1.97; P < 0.001). Sensitivity and subgroup analyses were performed to adjust for confounders, including head trauma, diabetes mellitus, hypertension, stroke, and obesity. Sleep apnea was demonstrated to be an independent risk factor for vertigo.
This is the first nationwide population-based cohort study to investigate the association between sleep apnea and vertigo. The findings strongly support that sleep apnea is an independent risk factor for vertigo. Based on the study results, physicians should be aware of potential vertigo occurrence following sleep apnea.
探讨睡眠呼吸暂停患者发生眩晕的风险。
回顾性队列研究。
本研究使用了台湾国民健康保险研究数据库的数据，这是一个基于人群的数据库。从2000年纵向健康保险数据库中识别出1997年1月1日至2012年12月31日期间新诊断为睡眠呼吸暂停的5025例患者，该数据库是一个具有全国代表性的数据库，随机选取了100万患者。此外，按照年龄、性别、社会经济地位和城市化水平以1:4的比例匹配了20100例无睡眠呼吸暂停的患者。对患者进行随访直至死亡或研究期结束（2013年12月31日）。主要结局是眩晕的发生。
睡眠呼吸暂停患者眩晕的累积发病率显著高于无睡眠呼吸暂停的患者（P < 0.001）。调整后的Cox比例风险模型显示，睡眠呼吸暂停与较高的眩晕发病率显著相关（风险比，1.71；95%置信区间[CI]，1.48 - 1.97；P < 0.001）。进行了敏感性和亚组分析以调整混杂因素，包括头部外伤、糖尿病、高血压、中风和肥胖。睡眠呼吸暂停被证明是眩晕的独立危险因素。
这是第一项基于全国人群的队列研究，旨在探讨睡眠呼吸暂停与眩晕之间的关联。研究结果有力地支持了睡眠呼吸暂停是眩晕的独立危险因素这一观点。基于研究结果，医生应意识到睡眠呼吸暂停后可能发生眩晕。
4。《喉镜》，128:763 - 768，2017年。
