Chia-Ming Yen1, Chi-Ling Kuo2, Ming-Chia Lin3, Chun-Feng Lee4, Kuan-Yu Lin5, Cheng-Li Lin6, Shih-Ni Chang7, Fung-Chang Sung8, Chia-Hung Kao9. 1. Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan. 2. Department of Nuclear Medicine, New Taipei City Hospital, Sanchong Branch, Taipei, Taiwan. 3. Department of Nuclear Medicine, E-DA Hospital, Kaohsiung, Taiwan. 4. Department of Oral and Maxillofacial Surgery, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan. 5. Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan. 6. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 7. Department of Medical Research, Taichung Veterans General Hospital, Taiwan. 8. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Electronic address: fcsung@mail.cmu.edu.tw. 9. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
Abstract
BACKGROUND: This study evaluated the relationship between sleep disorders (SDs) and osteoporosis risk in Taiwan. METHODS: From the Taiwan National Health Insurance data, we identified 44,690 newly diagnosed SD patients (846 with apnea and 43,844 without) from 1998 to 2001 and 89,380 comparisons without SD in the same period frequency matched by sex, age and diagnosis year. Incident osteoporosis was measured by the end of 2010. RESULT: Patients with apnea-SD and nonapnea SD exhibited a higher osteoporosis incidence rate than did the comparisons (9.97 and 13.3 vs. 6.77 per 1000 person-years, respectively). The Cox method estimated adjusted hazard ratio (HR) of osteoporosis was 2.98 (95% confidence interval [CI] = 2.36-3.74) in apnea-SD patients, compared with 2.76 (95% CI = 2.64-2.88) in nonapnea-SD patients after controlling for sex, age, comorbidities, and treatment. Greater HRs of osteoporosis were observed for female patients (4.00, 95% CI = 3.72-4.29) and those aged >64 years (42.0, 95% CI = 33.5-52.7) in the apnea SD sub-cohort. Apnea SD was associated with the highest risk of osteoporosis without fracture compared with both the nonapnea SD sub-cohort and comparisons. CONCLUSION: Patients with sleep disorders have an elevated risk of osteoporosis, especially for women and the elderly.
BACKGROUND: This study evaluated the relationship between sleep disorders (SDs) and osteoporosis risk in Taiwan. METHODS: From the Taiwan National Health Insurance data, we identified 44,690 newly diagnosed SDpatients (846 with apnea and 43,844 without) from 1998 to 2001 and 89,380 comparisons without SD in the same period frequency matched by sex, age and diagnosis year. Incident osteoporosis was measured by the end of 2010. RESULT: Patients with apnea-SD and nonapnea SD exhibited a higher osteoporosis incidence rate than did the comparisons (9.97 and 13.3 vs. 6.77 per 1000 person-years, respectively). The Cox method estimated adjusted hazard ratio (HR) of osteoporosis was 2.98 (95% confidence interval [CI] = 2.36-3.74) in apnea-SDpatients, compared with 2.76 (95% CI = 2.64-2.88) in nonapnea-SDpatients after controlling for sex, age, comorbidities, and treatment. Greater HRs of osteoporosis were observed for female patients (4.00, 95% CI = 3.72-4.29) and those aged >64 years (42.0, 95% CI = 33.5-52.7) in the apnea SD sub-cohort. Apnea SD was associated with the highest risk of osteoporosis without fracture compared with both the nonapnea SD sub-cohort and comparisons. CONCLUSION:Patients with sleep disorders have an elevated risk of osteoporosis, especially for women and the elderly.
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