Obstructive Sleep Apnea
Conditions
Keywords
Obstructive sleep apnea, National Health Insurance Research Database in Taiwan, Survival Analysis, Validation Studies, Cohort Studies
Brief summary
The purpose of this study is to explore long-term prognosis and to identify the predictors in Taiwanese OSA patients. Validation of the prediction model derived from NHIRD with the database of National Taiwan University Hospital (NTUH) sleep center is planed to determine the effects of different treatments on long-term prognosis.
Detailed description
Obstructive sleep apnea (OSA) is a common disorder characterized by intermittent hypoxia and sleep fragmentation. OSA is associated with cardiovascular morbidity and mortality, metabolic dysregulation, and neurocognitive dysfunction, which may bring worse prognosis. Continuous positive airway pressure (CPAP) is the standard treatment of OSA while the oral appliance and surgery are the alternative treatments. The differences of craniofacial features among races contributed to the race-specific presentations of OSA. Up to date, only limited studies investigated the long-term prognosis of OSA and most of them recruited Caucasians and African Americans. Moreover, most studies didn't address the impact of treatment other than CPAP on the long-term prognosis. . National Health Insurance Research Database (NHIRD) in Taiwan enrolled 99% of whole Taiwan's population and has longer period of 10 years for follow-up, which is suitable for investigation of long-term prognosis and predictors in OSA. However, due to limited parameters for diagnosis and treatment, the results could be biased in such secondary database research. Center of Sleep Disorder in National Taiwan University Hospital (NTUH) established from 2006 has 2,600 sleep studies annually. Therefore, database and cohort from sleep center could offer the validations of the prognosis and predictors determined from NHIRD. In addition, the impact of all three treatment modalities, namely CPAP, oral appliance, and surgery, on long-term prognosis could be studied in the prospective way. Therefore, in this project, we aimed to achieve three goals (1) To explore long-term prognosis and identify the predictors in Taiwanese OSA patients with NHIRD, where the prediction mode of prognosis was established (2). To validate the prediction model derived from NHIRD with the database of NTUH sleep center (3) To determine the effects of different treatments on long-term prognosis with prospective following NTUH sleep center cohort.
Interventions
None listed
Sponsors
National Taiwan University Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* NHIRD - \>=20 y/o; OSA ICD-9-CM code: 780.51,780.53,780.57, or 327.23; coexisted with PSG procedure code: 17008B,17008A. * NTUH cohort - \>=20 y/o; PSG AHI\>5
Exclusion criteria
* patients refusing to anticipate our study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Death or Major adverse cardiovascular events(MACEs) | from 2000 to 2013, up to 13 years | MACEs includes cardiogenic death, ischemic stroke, myocardial injury or acute coronary syndrome requiring revascularization. Data from NHIRD (database screening retrospectively) and NTUH cohort (recallable history taking). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cardiovascular morbidity | from 2000 to 2013, up to 13 years | Timing and events of new onset of hypertension, atrial fibrillation, or atrial flutter |
| Neurocognitive morbidity, up to 13 years | from 2000 to 2013, up to 13 years | Timing and events of traffic accident, new onset of depression, or dementia, or epilepsy. |
| Metabolic morbidity | from 2000 to 2013, up to 13 years | Timing and events of incident diabetics or diabetic complications or new onset of dyslipidemia. |
| Other morbidity | from 2000 to 2013, up to 13 years | Incidence of malignancy or chronic kidney disease. |
Countries
Taiwan
Contacts
Primary ContactMing-Tzer Lin, M.D.
Outcome results
None listed