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Sleep apnea increased risk for pneumonia
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Pneumonia is more likely to develop in patients with sleep apnea, according to a Taiwanese research team.
“This study showed that sleep apnea is an independent risk factor for incident pneumonia,” Kun-Ta Chou, MD, of the department of chest medicine at Taipei Veterans General Hospital in Taiwan, and colleagues wrote in the Canadian Medical Association Journal. “Our results also demonstrated an exposure-response relation in that patients with more severe sleep apnea may have higher risk of pneumonia than patients with sleep apnea of milder severity.”
Kun-Ta Chou
The researchers followed 6,816 patients with sleep apnea for 11 years. A control group (n=27,284) that did not have the condition, matched for age, sex and comorbidities, was selected for comparison. The primary endpoint was the development of pneumonia, which was validated by two radiologists.
Of the entire cohort, approximately 8% developed pneumonia, including 9.36% of sleep apnea patients and 7.77% of controls. Additional analyses suggested a higher incidence of pneumonia among patients with the sleep disorder (P<.001).
Adjusting for certain confounders, the researchers found that patients with sleep apnea experienced a 1.2-fold (95% CI, 1.10-1.31) increase in incident pneumonia. This risk increased with the severity of the disorder. For example, compared with the control group, the adjusted HR for patients with sleep apnea who needed continuous positive airway pressure (CPAP) treatment was 1.32 (95% CI, 1.12-1.55), and 1.15 (95% CI, 1.04-1.27) for those who did not need CPAP.
According to the researchers, patients with obstructive sleep apnea are at higher risk for aspiration, which may enable pathogens to enter the lower respiratory tract from saliva or other oral contents. Also, impaired immunity as a result of disrupted sleep may increase patients’ susceptibility to pathogens. Taken together, these conditions may increase the likelihood of developing pneumonia.
“Sleep apnea may confer a higher risk for pneumonia development,” Chou told Infectious Disease News. “For pneumonia patients without other identified risk factors, a survey of sleep disorders is recommended.” – John Schoen
For more information:
Kun-Ta Chou, MD, can be reached at 14F, No. 201, Sec. 2, Shi-Pai Rd., Taipei, Taiwan.
Disclosure: The researchers report no relevant financial disclosures.
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