Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Sleep. 2018 Jan 1;41(1). doi: 10.1093/sleep/zsx186.
Non-apnea sleep disorder (NASD) increases the risk of hypertension, type 2 diabetes mellitus, chronic kidney disease, cardiovascular disease, and stroke. However, the risk and the time interval of NASD to female infertility has not been thoroughly understood. Our study aimed to determine whether NASD increases the subsequent risk of female infertility.
This study utilized outpatient and inpatient data from the Longitudinal Health Insurance Database between 2000 and 2010 in Taiwan. We enrolled 50,154 females aged 20 to 45 years old and diagnosed with NASD as outpatients ≥2 times or hospitalized, 16,718 of them who matched our criteria were assigned to the study group. For each NASD patient, two comparison patients were frequency matched by age (each 5-year span), index date, and comorbidities as the control cohort with a total of 33,436 patients. We conducted Cox proportional hazard regression analysis to estimate the effects of NASD on female infertility.
The NASD cohort had an adjusted hazard ratio (HR) of subsequent female infertility of 3.718-fold higher than that of the cohort without sleep disorders. In the stratified age group, NASD had the highest impact on 26-30 years old, with an adjusted HR of 5.146 followed by 31-35 years old (adjusted HR = 3.356). The Kaplan-Meier analysis also showed that in the sixth year of follow-up, the incidence of female infertility was higher in the NASD cohort than in the general population cohort till the end of the follow-up.
Our study demonstrates that NASD patients are at a higher risk of developing female infertility.
非呼吸暂停性睡眠障碍（NASD）会增加高血压、2 型糖尿病、慢性肾脏病、心血管疾病和中风的风险。然而，NASD 对女性不孕的风险及其时间间隔尚未被充分了解。我们的研究旨在确定 NASD 是否会增加女性不孕的后续风险。
本研究利用了台湾 2000 年至 2010 年期间的门诊和住院患者的纵向健康保险数据库的数据。我们纳入了 50154 名年龄在 20 至 45 岁之间的女性，她们被诊断为门诊至少 2 次或住院患有 NASD，其中 16718 名符合我们标准的患者被分配到研究组。对于每例 NASD 患者，通过年龄（每 5 年一个间隔）、索引日期和合并症与对照组进行频率匹配，共纳入 33436 例患者。我们采用 Cox 比例风险回归分析来估计 NASD 对女性不孕的影响。
NASD 组发生女性不孕的调整后风险比（HR）是无睡眠障碍组的 3.718 倍。在分层的年龄组中，NASD 对 26-30 岁的影响最大，调整后 HR 为 5.146，其次是 31-35 岁（调整后 HR = 3.356）。Kaplan-Meier 分析也表明，在随访的第六年，NASD 组的女性不孕发生率高于一般人群组，直至随访结束。
我们的研究表明，NASD 患者发生女性不孕的风险更高。
