title: Obstructive sleep apnea and the risk of autoimmune diseases: a longitudinal population-based study.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) has been associated with chronic inflammation. However, no data regarding the risk for autoimmune disease in patients with OSA has been reported. This study aims to investigate the longitudinal risk for the development of certain autoimmune diseases in patients with OSA.
  
  
  METHODS
  For the study cohort, we identified 1411 patients from the Taiwan Longitudinal Health Insurance Database who had a diagnosis of OSA. For controls, 7055 subjects matched in terms of sex, age, and the index year were randomly extracted from the same database. Each patient was tracked for a five-year period to identify those patients who had received a diagnosis of rheumatoid arthritis (RA), ankylosing spondylitis (AS), or systemic lupus erythematous (SLE). Stratified Cox proportional hazard regression was performed on the two cohorts to compute the risk of autoimmune diseases during follow-up period.
  
  
  RESULTS
  Of 8466 patients, 1.76% had developed autoimmune diseases during the five-year follow-up period; 2.91% and 1.53% for the study cohort and the controls, respectively. The stratified Cox proportional analysis revealed that, after eliminating individuals who died during the follow-up period and adjusting for geographic and socioeconomic factors, the hazard for developing autoimmune disease during the five-year follow-up period was 1.91 (95% CI=1.32-2.77, p<0.001) times greater for patients with OSA than for controls.
  
  
  CONCLUSIONS
  Patients with OSA have a higher risk of developing certain autoimmune diseases. Further study is advised to confirm our findings and explore the underlying pathomechanism.
authors.affiliation: Sleep Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Jiunn-Horng
authors.initials: JH
authors.lastname: Kang
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology; D001327:Autoimmune Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D012959:Socioeconomic Factors; D013167:Spondylitis, Ankylosing / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology