title: Assessment of multiple health risks in a single obstructive sleep apnea population.
abstract: OBJECTIVE
  In order to provide a comprehensive estimate of the health risks for OSA patients, we analyzed multiple outcomes and independent predictors of these outcomes in an OSA population evaluated and followed at one sleep center.
  
  
  METHODS
  Cox proportional hazard regression analyses were used in an 8-year follow-up analysis of consecutive OSA patients (N = 1025) and non-apneic snorers (apnea-hypopnea index < 5, N = 494).
  
  
  RESULTS
  In our fully adjusted model, independent variables predictive of all-cause mortality, myocardial infarction, cerebral vascular accident, and pulmonary embolus were: older age, male gender, and history of cardiovascular diseases or procedures. In examining subgroups based on age and gender, severe OSA (AHI ≥ 30) was one of the independent predictors of mortality in males and in patients < 50 years old. Severe OSA interacted with maleness, age, and hypertension to predict mortality and myocardial infarction. CPAP use ≥ 4 h/night was associated with lower mortality rates in males and those ≥ 50 years old with severe OSA.
  
  
  CONCLUSIONS
  Mortality and cardiovascular event outcomes were predicted by demographics and cardiovascular disease history more commonly than by OSA severity. OSA severity was an important predictor of mortality in male and young OSA patients. CPAP use appeared protective in older and male severe OSA patients.
authors.affiliation: Sleep Disorders Centre, Section of Respirology, University of Manitoba, Winnipeg. hudgeldavid@yahoo.com
authors.forename: David W
authors.initials: DW
authors.lastname: Hudgel
authors.forename: Lois E
authors.initials: LE
authors.lastname: Lamerato
authors.forename: Gordon R
authors.initials: GR
authors.lastname: Jacobsen
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Drake
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D010349:Patient Compliance; D017286:Polysomnography; D016016:Proportional Hazards Models; D011655:Pulmonary Embolism / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000401:mortality / Q000628:therapy; D020521:Stroke / Q000209:etiology