Obstructive sleep apnea increases the risk of injuries- A nationwide population-based retrospective study

Study Objectives: Obstructive sleep apnea (OSA) has been reported with increased risk of motor vehicle accidents (MVA). However, there were no systemic studies to date studying OSA and its effect of injuries to the general population. Our study aimed to study whether OSA increases the risk of injuries. Methods: We utilized the outpatient and inpatient data from Taiwan’s National Health Insurance Research Database between 2000 and 2013. Our study enrolled 3,543 individuals diagnosed with OSA as outpatients≧3 times or hospitalized, and 3,025 of them were assigned to the study group. We calculated risks and incidence ratios of injuries in OSA patients compared with the general population. We conducted Cox proportional hazard regression analysis to estimate the effects of OSA on injuries. We have further studied the mechanism of injuries as well as age, sex and comorbidities to evaluate their interactions in OSA patients. Results: The incidence rate of injuries in the OSA group is 2599.09 per 105 person-years. The OSA cohort has an adjusted hazard ratio (HR) of injuries 77.7% higher than that of the cohort without OSA. Male are dominant in our studies and they also have higher risk of injuries compared to female (adjusted HR= 1.783 in male, 1.744 in female; p<0.001). Moreover, as to the mechanism of injuries, we have found that traffic accidents and falling are the two leading causes of injuries in OSA patients. Conclusions: Our study provides a nationwide, population based retrospective data demonstrating that OSA patients are at a higher risk of injuries.