title: Sleep disorders increase the risk of venous thromboembolism in individuals without sleep apnea: a nationwide population-based cohort study in Taiwan.
abstract: OBJECTIVE
  Studies investigating the relationship between sleep disorders (SDs) and the risk of venous thromboembolism (VTE) are scarce. The present study from Taiwan evaluated whether the risk of VTE was associated with SDs other than sleep apnea.
  
  
  METHODS
  The present study investigated the incidence and risk of VTE in 46,371 people with SDs, compared with 92,742 controls without SDs. The follow-up period began from the date of entering the study cohort to the date of a VTE event, censoring, or December 31, 2011. A Cox proportional hazards regression analysis was conducted to estimate the effects of SDs on the risk of VTE.
  
  
  RESULTS
  The SD cohort had a 1.79-fold adjusted hazard ratio (HR) of subsequent VTE, compared with the non-SD cohort (95% CI 1.49-2.16). The incidence of VTE increased with age for both cohorts but was higher for those in the SD cohort. However, the adjusted HRs for VTE were significantly higher for the people with SDs aged ≦49 years (HR 3.29, 95% CI 2.12-5.12) and 50-64 years (HR 2.43, 95% CI 1.76-3.35), but were not significant for the oldest group (HR 1.11, 95% CI 0.84-1.47), compared with the controls. The multiplicative increased risk of VTE was significant for the people with SDs with any comorbidity.
  
  
  CONCLUSIONS
  This nationwide cohort study determined that the VTE risk significantly increased in people with SDs compared with those of the general population.
authors.affiliation: Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan.
authors.forename: Wei-Sheng
authors.initials: WS
authors.lastname: Chung
authors.affiliation: Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Yung-Fu
authors.initials: YF
authors.lastname: Chen
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Shih-Ni
authors.initials: SN
authors.lastname: Chang
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Wu-Huei
authors.initials: WH
authors.lastname: Hsu
authors.affiliation: 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.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000150:complications*; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology*
keywords: Cox proportional hazards regression analysis; Hazard ratio; Population-based cohort study; Sleep disorders; Venous thromboembolism