Article Abstract

Sleep apnea and risk of traumatic brain injury and associated mortality and healthcare costs: a population-based cohort study

Authors: Shih-Yi Lin, Weishan Chen, Tomor Harnod, Cheng-Li Lin, Wu-Huei Hsu, Cheng-Chieh Lin, Yun-Lun Chang, I-Kuan Wang, Chia-Hung Kao

Abstract

Background: The objective of this study was aimed to investigate whether sleep apnea patients had a higher risk of traumatic brain injury.
Methods: Data were collected from the Taiwan Longitudinal Health Insurance Database during the period of 2000–2012. The study cohort comprised 6,456 patients aged ≥20 years with a first diagnosis of sleep apnea. The primary outcome was the incidence of traumatic brain injury. Kaplan-Meier survival analysis and Cox proportional-hazards modeling were used.
Results: After adjustments for associated comorbidities and hypnotic medications, sleep apnea patients were associated with a 1.19-fold higher risk of traumatic brain injury (95% CI, 1.07–1.33) compared with patients without sleep apnea. Sleep apnea patients who took benzodiazepine (BZD) had a 1.30-fold increased risk of traumatic brain injury compared with patients without sleep apnea (95% CI, 1.14–1.49). However, this risk was not statistically significant, with a 1.03-fold risk of traumatic brain injury in sleep apnea patients without BZD use (95% CI, 0.84–1.25) compared with patients without sleep apnea. Compared with patients without sleep apnea, the risk of traumatic brain injury in sleep apnea patients aged 65–79 years old was higher (adjusted hazard ratio, 1.36; 95% CI, 1.06–1.74).
Conclusion: Sleep apnea patients, regardless of hypnotic use, had a higher risk of traumatic brain injury compared with patients without sleep apnea.