Influence of Lung Function and Sleep-disordered Breathing on All-Cause Mortality. A Community-based Study

Area of Science:

• Pulmonary Medicine
• Sleep Medicine
• Epidemiology

Background:

• Sleep-disordered breathing (SDB) and reduced lung function are common in adults.
• The combined impact of SDB severity and lung function on mortality is debated.

Purpose of the Study:

• To investigate if the association between lower lung function and mortality is stronger with increasing SDB severity.
• To analyze this relationship in a community-based cohort of middle-aged and older adults.

Main Methods:

• Utilized data from 6,173 participants in the Sleep Heart Health Study.
• Analyzed spirometry and home sleep testing data, focusing on FEV1 and apnea-hypopnea index (AHI).
• Employed proportional hazards models to assess all-cause mortality risk.

Main Results:

• Mortality rates were higher in individuals with SDB (26.9 per 1,000 person-years) compared to those without (18.2 per 1,000 person-years).
• Each 200-ml decrease in FEV1 increased mortality by 11.0% in those without SDB, versus 6.0% in those with SDB.
• A significant interaction (P=0.004) indicated that the influence of lung function on mortality decreased as SDB severity increased.

Conclusions:

• Lung function is independently associated with all-cause mortality risk.
• The impact of lung function on mortality risk is attenuated in individuals with more severe sleep-disordered breathing.