Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Penghu Hospital, Ministry of Health and Welfare, Penghu, Taiwan.
Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.
Sleep Med. 2023 Jan;101:197-204. doi: 10.1016/j.sleep.2022.10.031. Epub 2022 Nov 17.
Obstructive sleep apnea (OSA) and alcohol-related diseases (ARDs), including alcohol use disorder, alcohol-related psychiatric disorders, alcoholic liver disease, alcoholic polyneuropathy alcoholic cardiomyopathy, and alcoholic gastritis, are both highly prevalent conditions. Alcohol consumption is associated with a higher risk of sleep apnea. However, whether OSA increases the risk of ARD has not, as yet, been studied comprehensively. Our study aimed to determine whether OSA increases the subsequent risk of ARD.
This study utilized the data from Taiwan's National Health Insurance Database between 2000 and 2015. We identified 7722 individuals newly diagnosed with OSA and randomly selected sex-, age-, and index date-matched (1:3) 22,166 controls without OSA, with a total of 29,888 subjects. We used the Fine and Gray's survival analysis to estimate the effects of OSA on ARD.
The OSA cohort had an adjusted hazard ratio of subsequent ARDs as 1.486 (95% Confidence Interval: 1.301-1.698), when comparing the cohort without OSA. The Kaplan-Meier analysis showed that the cumulative incidence of ARDs was significantly higher in the OSA cohort than in the controls in the first year of follow-up, till the end of the follow-up. A post-hoc analysis showed that OSA was associated with alcohol use disorder, alcohol-related psychiatric disorders, and alcoholic liver disease, but not alcoholic polyneuropathy, alcoholic cardiomyopathy, and alcoholic gastritis. The use of psychoactive medication, including the sedative-hypnotics, antidepressants or antipsychotics were associated with a lower risk of ARDs.
Our study demonstrates that the OSA patients are at a higher risk of developing ARDs.
阻塞性睡眠呼吸暂停（OSA）和与酒精相关的疾病（ARDs），包括酒精使用障碍、酒精相关精神障碍、酒精性肝病、酒精性多发性神经病、酒精性心肌病和酒精性胃炎，都是高患病率的疾病。饮酒与睡眠呼吸暂停的风险增加有关。然而，OSA 是否会增加 ARD 的风险尚未得到全面研究。我们的研究旨在确定 OSA 是否会增加随后发生 ARD 的风险。
本研究利用了台湾 2000 年至 2015 年期间的国家健康保险数据库的数据。我们确定了 7722 名新诊断为 OSA 的个体，并随机选择了性别、年龄和索引日期相匹配（1:3）的 22166 名无 OSA 的对照者，共有 29888 名受试者。我们使用 Fine 和 Gray 的生存分析来估计 OSA 对 ARD 的影响。
与无 OSA 的对照组相比，OSA 队列的后续 ARD 的调整后危险比为 1.486（95%置信区间：1.301-1.698）。Kaplan-Meier 分析显示，在随访的第一年及随访结束时，OSA 队列的 ARD 累积发生率明显高于对照组。事后分析显示，OSA 与酒精使用障碍、酒精相关精神障碍和酒精性肝病有关，但与酒精性多发性神经病、酒精性心肌病和酒精性胃炎无关。使用包括镇静催眠药、抗抑郁药或抗精神病药在内的精神活性药物与 ARD 的风险降低相关。
我们的研究表明，OSA 患者发生 ARD 的风险更高。
