Division of Respiratory Therapy, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Department of Chinese Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Postgrad Med. 2024 Jan;136(1):22-29. doi: 10.1080/00325481.2023.2288562. Epub 2023 Dec 1.
Diseases associated with chronic pain are typically a major source of stress for patients; and have been linked to herpes zoster (HZ) development. Here, we investigated whether obstructive sleep apnea (OSA) is a potential stressor that increases the risk of HZ and postherpetic neuralgia (PHN) in affected individuals.
The data used in this study were obtained from the National Health Insurance Research Database. The study cohort included patients aged between 20 and 100 years who had OSA during the period from 2000 to 2017 (with tracking completed until 2018). The case group and the control group were matched at a 1:1 ratio on the basis of age, sex, comorbidities, and index year, with patients who had outcomes before the index date being excluded. The outcomes considered in this study were HZ and PHN. The risk of HZ and PHN with and without OSA was calculated, and age, sex, comorbidities, and index year were adjusted for.
There were 25,211 patients in each group. Patients with OSA had a significantly higher risk of HZ (adjusted hazard ratio [aHR] = 1.22) than those without did. The patients with OSA had also a significantly higher risk of PHN (aHR = 1.36) than those without did. In term of comorbidities, the patients with OSA without (aHR = 1.28) and with (aHR = 1.17) comorbidities had a significantly higher risk of HZ compared with those without OSA. In addition, the patients with OSA but no other comorbidities (aHR = 1.68) had a significantly higher risk of PHN than those without did.
OSA increases the risk of not only HZ but also PHN. Therefore, patients with OSA should be aware of the potential effect of the disease on their stress levels, as well as the increased risk of developing HZ and PHN.
与慢性疼痛相关的疾病通常是患者的主要压力源；并与带状疱疹（HZ）的发展有关。在这里，我们研究了阻塞性睡眠呼吸暂停（OSA）是否是一个潜在的应激源，会增加受影响个体患 HZ 和疱疹后神经痛（PHN）的风险。
本研究使用的数据来自国家健康保险研究数据库。研究队列包括 20 岁至 100 岁之间在 2000 年至 2017 年期间患有 OSA 的患者（跟踪至 2018 年）。病例组和对照组按照年龄、性别、合并症和索引年份以 1:1 的比例匹配，排除在索引日期之前有结局的患者。本研究考虑的结局是 HZ 和 PHN。计算了有和没有 OSA 的 HZ 和 PHN 的风险，并对年龄、性别、合并症和索引年份进行了调整。
每组各有 25211 名患者。患有 OSA 的患者发生 HZ 的风险明显高于未患有 OSA 的患者（调整后的危险比[aHR] = 1.22）。患有 OSA 的患者发生 PHN 的风险也明显高于未患有 OSA 的患者（aHR = 1.36）。就合并症而言，患有 OSA 但无其他合并症的患者（aHR = 1.68）发生 PHN 的风险明显高于无 OSA 的患者。此外，患有 OSA 但无其他合并症的患者（aHR = 1.28）发生 HZ 的风险明显高于无 OSA 的患者。
OSA 不仅会增加 HZ 的风险，还会增加 PHN 的风险。因此，患有 OSA 的患者应该意识到该疾病对其压力水平的潜在影响，以及患 HZ 和 PHN 的风险增加。
