title: Sleep disorders and increased risk of autoimmune diseases in individuals without sleep apnea.
abstract: OBJECTIVE
  To explore the association between the non-apnea sleep disorder (NSD) and autoimmune diseases.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Nationwide database research.
  
  
  METHODS
  84,996 adult patients with NSD diagnoses recorded in the Taiwan National Health Insurance Research Database between 2000 and 2003, after excluding those with antecedent autoimmune diseases. A comparison cohort of 84,996 participants was formed by age-, gender-, income-, and urbanization-matched controls.
  
  
  METHODS
  None.
  
  
  RESULTS
  The two cohorts were followed up for occurrence of autoimmune diseases, including rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), and systemic sclerosis (SSc). A Cox proportional hazards regression model was used for muti-variate adjustment. In patients with NSD, the overall risk for incident autoimmune diseases was significantly higher than in controls (adjusted hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.41-1.53). With regard to individual diseases, the risks for SLE, RA, AS and SS among NSD patients were also significantly higher than in controls (HR [95% CI] for SLE, RA, AS, and SS were 1.81 [1.50-2.18], 1.45 [1.36-1.54], 1.53 [1.38-1.70], and 1.51 [1.43-1.60], respectively), whereas the increased risk for SSc did not reach statistical significance (HR: 1.36 [0.82-2.26]).
  
  
  CONCLUSIONS
  Patients with non-apnea sleep disorder were associated with a higher risk for developing autoimmune diseases.
authors: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Yi-Han
authors: YH
authors: Hsiao
authors: Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan.
authors: Yung-Tai
authors: YT
authors: Chen
authors: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Section of Respiratory Therapy, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei, Taiwan.
authors: Ching-Min
authors: CM
authors: Tseng
authors: Department of Radiology, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan.
authors: Li-An
authors: LA
authors: Wu
authors: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Wei-Chen
authors: WC
authors: Lin
authors: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Vincent Yi-Fong
authors: VY
authors: Su
authors: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Diahn-Warng
authors: DW
authors: Perng
authors: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Shi-Chuan
authors: SC
authors: Chang
authors: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Yuh-Min
authors: YM
authors: Chen
authors: Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Tzeng-Ji
authors: TJ
authors: Chen
authors: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Yu-Chin
authors: YC
authors: Lee
authors: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Kun-Ta
authors: KT
authors: Chou
mesh_terms: D001172:Arthritis, Rheumatoid / Q000453:epidemiology; D001327:Autoimmune Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007182:Income / Q000706:statistics & numerical data; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000453:epidemiology; D012859:Sjogren's Syndrome / Q000453:epidemiology; D012891:Sleep Apnea Syndromes; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D013167:Spondylitis, Ankylosing / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
keywords: autoimmune disease; autoimmunity; non-apnea sleep disorder; sleep disorder