title: Sleep Apnea and Risk of Panic Disorder.
abstract: OBJECTIVE
  Epidemiological studies have identified a trend in the development of depressive and anxiety disorders following a diagnosis of sleep apnea. The relationship between sleep apnea and subsequent panic disorder, however, remains unclear.
  
  
  METHODS
  Using a nationwide database, the Taiwan National Health Insurance Research Database, patients with sleep apnea and age-, sex-, income-, and urbanization-matched control patients who did not have sleep apnea were enrolled between 2000 and 2010. Patients with a prior diagnosis of panic disorder before enrollment were excluded. The 2 cohorts were observed until December 31, 2010. The primary endpoint was occurrence of newly diagnosed panic disorder.
  
  
  RESULTS
  A total of 8,704 sleep apnea patients and 34,792 control patients were enrolled. Of the 43,496 patients, 263 (0.60%) suffered from panic disorder during a mean follow-up period of 3.92 years, including 117 (1.34%) from the sleep apnea cohort and 146 (0.42%) from the control group. The Kaplan-Meier analysis revealed a predisposition of patients with sleep apnea to develop panic disorder (log-rank test, P <.001). After multivariate adjustment, the hazard ratio for subsequent panic disorder among the sleep apnea patients was 2.17 (95% confidence interval, 1.68-2.81; P <.001).
  
  
  CONCLUSIONS
  Sleep apnea appears to confer a higher risk for future development of panic disorder.
authors.affiliation: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Vincent Yi-Fong
authors.initials: VY
authors.lastname: Su
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Medicine, Heping-Fuyou Branch, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Lin
authors.affiliation: Department of Radiology, Heping-Fuyou Branch, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Li-An
authors.initials: LA
authors.lastname: Wu
authors.affiliation: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shi-Chuan
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Diahn-Warng
authors.initials: DW
authors.lastname: Perng
authors.affiliation: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wei-Juin
authors.initials: WJ
authors.lastname: Su
authors.affiliation: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yuh-Min
authors.initials: YM
authors.lastname: Chen
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.affiliation: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yu-Chin
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan ale1371@yahoo.com.tw.
authors.forename: Kun-Ta
authors.initials: KT
authors.lastname: Chou
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016584:Panic Disorder / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology
keywords: panic disorder; sleep apnea syndromes; sleep-disordered breathing