Obstructive sleep apnea and injury events in Taiwanese adults: A retrospective cohort study

Purpose: The aim of this study was to examine the association between obstructive sleep apnea (OSA) diagnosis and diverse types of injuries.

Design: This population-based retrospective cohort study compared records from 2000 to 2013 in the Taiwan National Health Insurance Research Database.

Methods: 3025 patients identified with OSA were compared against the control cohort consisting of 12,100 age- and sex-matched patients. Cox proportional hazards regression analysis was performed to estimate the effects of OSA on injury risk.

Findings: Patients with OSA exhibited a significantly higher overall incidence of injury of 2599 per 100,000 person-years compared to the control cohort (2248 per 100,000 person-years). After the confounding factors were considered, subjects with OSA showed a higher risk of injury than subjects in the control group (adjusted hazard ratio [HR] = 1.78, 95% confidence interval [CI] = 1.64-1.93). The risk of unintentional injury (traffic, poisoning, falls) and intentional injury (suicide) in the group of patients with OSA was higher than that in the controls.

Conclusions: Our study strongly supports the conclusion that adults with OSA are at increased risk of injury.

Clinical relevance: The present results indicate the significance of OSA as a predictor of injury risk, which will provide valuable information for clinical practice and injury prevention.