Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2014 Apr 1;186(6):415-21.
doi: 10.1503/cmaj.131547. Epub 2014 Mar 3.

Sleep apnea and risk of pneumonia: a nationwide population-based study

Vincent Yi-Fong Su, Chia-Jen Liu, Hsin-Kai Wang, Li-An Wu, Shi-Chuan Chang, Diahn-Warng Perng, Wei-Juin Su, Yuh-Min Chen, Elizabeth Ya-Hsuan Lin, Tzeng-Ji Chen, Kun-Ta Chou
Comparative Study

Sleep apnea and risk of pneumonia: a nationwide population-based study

Vincent Yi-Fong Su et al. CMAJ. .

Erratum in

  • CMAJ. 2014 Oct 7;186(14):1092

Abstract

Background: Evidence evaluating the risk of pneumonia in patients with obstructive sleep apnea is limited and mostly focuses on patients who receive continuous positive airway pressure (CPAP) therapy or on pediatric patients. We aimed to explore the risk of incident pneumonia among adults with sleep apnea, either with or without the need of CPAP therapy.

Methods: From Jan. 1, 2000, we identified adult patients with sleep apnea from the Taiwan National Health Insurance Research Database. A control cohort without sleep apnea, matched for age, sex and comorbidities, was selected for comparison. The 2 cohorts were followed until Dec. 31, 2010, and observed for occurrence of pneumonia.

Results: Of the 34,100 patients (6816 study patients and 27,284 matched controls), 2757 (8.09%) had pneumonia during a mean follow-up period of 4.50 years, including 638 (9.36%) study patients and 2119 (7.77%) controls. Kaplan-Meier analysis showed a higher incidence of pneumonia among patients with sleep apnea (log rank test, p < 0.001). After multivariate adjustment, patients with sleep apnea experienced a 1.20-fold (95% confidence interval 1.10-1.31) increase in incident pneumonia. The risk was even higher among patients who received CPAP therapy.

Interpretation: Sleep apnea appeared to confer a higher risk for future pneumonia, possibly in a severity-dependent manner.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Kaplan–Meier curves showing a significant difference in cumulative incidences of pneumonia among patients with sleep apnea and controls.
Figure 2:
Figure 2:
Multivariable analysis showing risk of pneumonia associated with patient characteristics and comorbidities. Values greater than 1.0 indicate an increased risk. CI = confidence interval, CKD = chronic renal disease, COPD = chronic obstructive pulmonary disease, GERD = gastroesophageal reflux disease, HR = hazard ratio.
Figure 3:
Figure 3:
Detailed multivariable analysis showing risk of pneumonia associated with patient characteristics and comorbidities. Values greater than 1.0 indicate an increased risk. CI = confidence interval, CKD = chronic renal disease, COPD = chronic obstructive pulmonary disease, GERD = gastroesophageal reflux disease, HR = hazard ratio.
See this image and copyright information in PMC

References

    1. He QY, Feng J, Zhang XL, et al. Sleep Breath Disorder Group; Society of Respiratory Medicine; Chinese Medical Association. Relationship of daytime blood pressure and severity of obstructive sleep apnea among Chinese: a multi-center investigation in China. Chin Med J (Engl) 2010;123:18–22 - PubMed
    1. Chen R, Xiong KP, Lian YX, et al. Daytime sleepiness and its determining factors in Chinese obstructive sleep apnea patients. Sleep & Breath 2011;15:129–135 - PubMed
    1. Epstein LJ, Kristo D, Strollo PJ, Jr, et al. Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009; 5:263–76 - PMC - PubMed
    1. Bucks RS, Olaithe M, Eastwood P. Neurocognitive function in obstructive sleep apnoea: a meta-review. Respirology 2013;18: 61–70 - PubMed
    1. Lattimore JD, Celermajer DS, Wilcox I. Obstructive sleep apnea and cardiovascular disease. J Am Coll Cardiol 2003;41:1429–37 - PubMed

Publication types

MeSH terms