Age modifies the association between severe sleep apnea and all-cause mortality

Area of Science:

• Gerontology
• Sleep Medicine
• Epidemiology

Background:

• Sleep apnea (SA) prevalence increases with age, yet its impact on health outcomes across different age groups remains unclear.
• Understanding age-related differences in SA's association with mortality is crucial for public health.
• Large-scale longitudinal data is needed to investigate these associations.

Purpose of the Study:

• To assess the association between the severity of sleep apnea (SA) and all-cause mortality across various age groups.
• To determine how age modifies the relationship between SA and mortality risk.
• To analyze mortality data in relation to sleep apnea severity in young, middle-aged, and older adults.

Main Methods:

• A Natural Language Processing pipeline extracted the apnea-hypopnea index (AHI) from sleep study interpretations.
• Participants were categorized into no SA (AHI<5) and severe SA (AHI≥30) groups.
• The cohort was divided into age groups (Young ≤40, Middle-aged 40-65, Older adults ≥65) and mortality was analyzed adjusting for covariates.

Main Results:

• Severe SA prevalence increased with age in a cohort of 146,148 participants.
• Overall, severe SA was associated with lower all-cause mortality (aOR 0.56).
• The protective association of severe SA against mortality diminished with increasing age, becoming less pronounced in older adults (Young: aOR 1.11; Middle-aged: aOR 0.64; Older adults: aOR 0.44).

Conclusions:

• Severe sleep apnea prevalence rises with age, but its association with reduced mortality risk decreases in older individuals.
• These findings suggest that sleep apnea may have less detrimental effects on mortality in the elderly.
• Further causal analysis is recommended to explore the interplay between sleep apnea, aging, and all-cause mortality.