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Overall Mortality and Comorbidities in Obstructive Sleep Apnea in Poland
Wojciech Kuczyński1, Aleksandra Kudrycka1, Karol Pierzchała1
1Department of Sleep Medicine and Metabolic Disorders, Medical University of Łódź, Łódź, Poland.
Summary
Obstructive sleep apnea (OSA) increases mortality risk. Sleepiness, stroke history, and certain medications predict death, highlighting the need for comprehensive OSA management beyond just the apnea-hypopnea index (AHI).
Area of Science:
- Sleep Medicine
- Cardiovascular Research
- Epidemiology
Background:
- Obstructive sleep apnea (OSA) is linked to severe health issues and mortality.
- Understanding predictors of mortality in OSA patients is crucial for effective management.
- This study examines factors influencing all-cause and OSA-related mortality over extended follow-up periods.
Purpose of the Study:
- To identify and compare predictors of all-cause and OSA-related mortality.
- To analyze mortality trends at 5, 10, and 15 years post-diagnosis.
- To evaluate the role of clinical symptoms, comorbidities, and polysomnographic findings in OSA mortality.
Main Methods:
- A longitudinal, single-center study of 4025 patients with suspected OSA undergoing polysomnography.
- Patients were followed for up to 15 years, categorized by mortality status and cause of death.
- Cox regression analyses were used to determine mortality predictors, comparing apnea-hypopnea index (AHI) during different sleep stages.
Main Results:
- The prevalence of OSA in the cohort was 75.6%. Survival rates decreased over time: 89.7% at 5 years, 81.9% at 10 years, and 78.8% at 15 years.
- Cardiovascular diseases (33.3%) and cancer (26.5%) were the leading causes of death.
- Higher mortality risk was associated with AHI during REM sleep (AHIREM), sleepiness, history of stroke, and use of new oral anticoagulants.
Conclusions:
- OSA management necessitates a comprehensive strategy beyond the apnea-hypopnea index (AHI).
- Integrating clinical symptoms, comorbidities, and specific polysomnographic indices like AHIREM is vital for improving patient outcomes.
- Early identification and management of risk factors are crucial for reducing mortality in OSA patients.
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