PT  - JOURNAL ARTICLE
AU  - Su, Vincent Yi-Fong
AU  - Liu, Chia-Jen
AU  - Wang, Hsin-Kai
AU  - Wu, Li-An
AU  - Chang, Shi-Chuan
AU  - Perng, Diahn-Warng
AU  - Su, Wei-Juin
AU  - Chen, Yuh-Min
AU  - Lin, Elizabeth Ya-Hsuan
AU  - Chen, Tzeng-Ji
AU  - Chou, Kun-Ta
TI  - Sleep apnea and risk of pneumonia: a nationwide population-based study
AID  - 10.1503/cmaj.131547
DP  - 2014 Apr 01
TA  - Canadian Medical Association Journal
PG  - 415--421
VI  - 186
IP  - 6
4099  - http://www.cmaj.ca/content/186/6/415.short
4100  - http://www.cmaj.ca/content/186/6/415.full
SO  - CMAJ2014 Apr 01; 186
AB  - 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.