All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment: a registry study with 10 years of follow-up
Authors Jennum P, Tønnesen P, Ibsen R, Kjellberg J
Received 30 September 2014
Accepted for publication 9 December 2014
Published 9 April 2015 Volume 2015:7 Pages 43—50
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Steven A Shea
Poul Jennum,1,2 Philip Tønnesen,1 Rikke Ibsen,3 Jakob Kjellberg4
1Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Glostrup Hospital, Copenhagen, Denmark; 2Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; 3itracks, Aarhus, Denmark, 4Danish National Institute for Local and Regional Government Research, Copenhagen, Denmark
Background: More information is needed about the effect on mortality of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA), especially in women.
Methods: We employed a historical cohort study design, using data from 25,389 patients with a diagnosis of OSA selected from the Danish National Patient Registry for the period 1999–2009. We used Cox proportional hazard function to evaluate the all-cause mortality from OSA in middle-aged and elderly males and females who were treated, or not, with CPAP.
Results: Female OSA patients had a lower mortality than males, irrespective of whether they received CPAP treatment. CPAP treatment improved survival, as illustrated by the hazard ratio of 0.62 (P<0.001). This effect was dependent on gender: CPAP had no significant effect on 20- to 39-year-old males and females, but the overall mortality in this age group was small. Survival was increased by CPAP in 40- to 59-year-old and ≥60-year-old males, but no such effect was observed in females. Positive predictors of survival were young age, female gender, higher educational level, and low 3-year prior comorbidity as estimated by the Charlson Comorbidity Index. Negative predictors for survival were male gender, age ≥60 years, no CPAP treatment, prior comorbidity, and low educational level.
Conclusion: CPAP therapy is associated with reduced all-cause mortality in middle-aged and elderly males, but no significant effect was found in females.
Keywords: middle age, elderly, gender, mortality
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