Evolving Burden of Cardiac Arrest Mortality in Sleep Apnea: A Nationwide Study From 1999 to 2024

Sleep apnea is recognized as a major contributor to cardiovascular morbidity and mortality, including sudden cardiac arrest. This study examines trends in cardiac arrest mortality among US adults with sleep apnea and evaluates disparities across demographic and geographic groups. A retrospective analysis was conducted utilizing the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research data from 1999 to 2024. This study included adults aged ≥25 years who were diagnosed with sleep apnea and cardiac arrest. Age-adjusted mortality rates (AAMRs) and annual percentage changes (APCs) were computed employing Joinpoint regression, stratified by sex, race/ethnicity, region, and urbanization. A total of 57,186 deaths related to cardiac arrest occurred within this population. AAMRs increased from 0.3 to 1.5 per 100,000 [APC, 6.08% (95% confidence interval, 5.60-6.86); P < 0.001], exhibiting a pronounced increase through 2021 (APC, 7.45%) followed by a plateau thereafter. A sex-stratified analysis indicated that mortality rates were higher in males (overall AAMR, 1.3) compared with females (0.6). Non-Hispanic (NH) Black individuals exhibited the highest overall AAMR (1.4), followed by NH White (0.9), Hispanic (0.7), and NH other (0.5). Regionally, the Western United States recorded the highest AAMR (1.2), with rural areas witnessing a more pronounced increase. Cardiac arrest mortality in patients with sleep apnea has escalated over 2 decades, particularly among men, racial minorities, and those in the Western United States. These findings underscore the need for targeted screening, equitable access to care, and public health strategies to mitigate cardiovascular risks in high-burden populations.