Osteoarthritis and the risk of sleep apnea: a general population-based cohort study

Osteoarthritis (OA) is the most common joint disease, leading to pain and inflammation, two risk factors for sleep apnea (SA). We aimed to examine whether OA may increase the risk of incident SA, a common source of mortality and sudden death.

Using data from the IQVIA Medical Research Database, we conducted three cohort studies (i.e., knee, hip, and hand cohort) among individuals aged 50 years or older. For each patient with incident OA, up to five non-OA individuals were matched by age, sex, entry-time, and BMI. We calculated the incidence rate of SA for the OA and non-OA cohorts, respectively, and examined the relation of OA to the risk of incident SA using a Cox proportional hazard model adjusting for potential confounders.

During the follow-up, 869 SA cases occurred in 58,674 patients with knee OA and 2,186 in 235,850 non-OA individuals (2.29 vs. 1.41/1000 person-years). Compared with the non-OA cohort, the multivariable-adjusted hazard ratio (HR) of SA in the knee OA cohort was 1.45 (95% confidence interval [CI]: 1.34-1.56). A higher risk of SA was also observed among patients with incident hip OA (adjusted HR: 1.45, 95%CI: 1.28-1.66) and hand OA (adjusted HR: 1.50, 95%CI: 1.26-1.78) than the matched non-OA individuals.

This general population-based study provides the first evidence that patients with knee, hip, and hand OA may have an increased risk of incident SA. Strategies aimed at screening, prevention, and treatment of SA could be developed to reduce the disease burden in OA patients.