Risk of Motor Vehicle Accidents in Obstructive Sleep Apnea: Comparative Analysis of CPAP Versus Surgery.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY Otolaryngology- Head and Neck Surgery Pub Date : 2025-01-21 DOI:10.1002/ohn.1131

Elliott M Sina, Somya Shankar, Maurits S Boon, Colin T Huntley

{"title":"Risk of Motor Vehicle Accidents in Obstructive Sleep Apnea: Comparative Analysis of CPAP Versus Surgery.","authors":"Elliott M Sina, Somya Shankar, Maurits S Boon, Colin T Huntley","doi":"10.1002/ohn.1131","DOIUrl":null,"url":null,"abstract":"Objective: To compare the incidence of motor vehicle accidents (MVAs) among patients with obstructive sleep apnea (OSA) undergoing continuous positive airway pressure (CPAP) therapy and sleep surgery.Study design: Retrospective cohort study using the TriNetX national clinical database.Setting: Analysis of a nationwide patient cohort.Methods: The database was queried for patients with OSA (International Classification of Diseases, 10th Revision: G47.33) treated with CPAP (Current Procedural Terminology [CPT]: 94660), sleep surgery (CPT: 42145, 64568, 64582), or no treatment. Sleep surgeries included uvulopalatopharyngoplasty and hypoglossal nerve stimulation. 1:1 Propensity score matching (PSM) ensured cohort comparability by age, sex, and race. MVA incidence rates were analyzed, along with a subanalysis of OSA-related comorbidities as a surrogate of OSA severity.Results: A total of 2,832,437 patients with OSA were identified. Patients with OSA undergoing sleep surgery demonstrated a significantly lower incidence of MVAs (3.403%) compared to the OSA + CPAP cohort (6.072%) and the no-treatment group (4.662%). The odds ratio (OR) for MVA incidence in the no-treatment group compared to the OSA + sleep surgery cohort was 1.214 (95% confidence interval [CI]: 1.060-1.391, P = .0051). The OR in the OSA + sleep surgery cohort compared to the CPAP cohort was 0.545 (95% CI: 0.480-0.618, P < .0001). Patients with OSA who experienced MVAs were more likely to have comorbidities such as hypertension, diabetes, and heart failure following the accident.Conclusion: Sleep surgery significantly reduces the risk of MVAs in patients with OSA compared to CPAP and no treatment. In appropriate candidates, surgery should be considered to mitigate personal and public health risks associated with OSA.","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otolaryngology- Head and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ohn.1131","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To compare the incidence of motor vehicle accidents (MVAs) among patients with obstructive sleep apnea (OSA) undergoing continuous positive airway pressure (CPAP) therapy and sleep surgery.

Study design: Retrospective cohort study using the TriNetX national clinical database.

Setting: Analysis of a nationwide patient cohort.

Methods: The database was queried for patients with OSA (International Classification of Diseases, 10th Revision: G47.33) treated with CPAP (Current Procedural Terminology [CPT]: 94660), sleep surgery (CPT: 42145, 64568, 64582), or no treatment. Sleep surgeries included uvulopalatopharyngoplasty and hypoglossal nerve stimulation. 1:1 Propensity score matching (PSM) ensured cohort comparability by age, sex, and race. MVA incidence rates were analyzed, along with a subanalysis of OSA-related comorbidities as a surrogate of OSA severity.

Results: A total of 2,832,437 patients with OSA were identified. Patients with OSA undergoing sleep surgery demonstrated a significantly lower incidence of MVAs (3.403%) compared to the OSA + CPAP cohort (6.072%) and the no-treatment group (4.662%). The odds ratio (OR) for MVA incidence in the no-treatment group compared to the OSA + sleep surgery cohort was 1.214 (95% confidence interval [CI]: 1.060-1.391, P = .0051). The OR in the OSA + sleep surgery cohort compared to the CPAP cohort was 0.545 (95% CI: 0.480-0.618, P < .0001). Patients with OSA who experienced MVAs were more likely to have comorbidities such as hypertension, diabetes, and heart failure following the accident.

Conclusion: Sleep surgery significantly reduces the risk of MVAs in patients with OSA compared to CPAP and no treatment. In appropriate candidates, surgery should be considered to mitigate personal and public health risks associated with OSA.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

阻塞性睡眠呼吸暂停的机动车事故风险：CPAP与手术的比较分析。

目的：比较阻塞性睡眠呼吸暂停（OSA）患者接受持续气道正压通气（CPAP）治疗与睡眠手术的机动车事故发生率。研究设计：采用TriNetX国家临床数据库进行回顾性队列研究。背景：对全国患者队列进行分析。方法：查询数据库中接受CPAP（现行程序术语[CPT]: 94660）、睡眠手术（CPT: 42145、64568、64582）或未接受治疗的OSA（国际疾病分类，第十版：G47.33）患者。睡眠手术包括舌腭咽成形术和舌下神经刺激。1:1倾向评分匹配（PSM）确保了年龄、性别和种族的队列可比性。分析了MVA的发病率，并对OSA相关合并症进行了亚分析，作为OSA严重程度的替代指标。结果：共发现2,832,437例OSA患者。与OSA + CPAP组（6.072%）和未治疗组（4.662%）相比，接受睡眠手术的OSA患者的MVAs发生率（3.403%）显著降低。与OSA +睡眠手术组相比，未治疗组MVA发生率的比值比（OR）为1.214（95%可信区间[CI]: 1.060-1.391, P = 0.0051）。与CPAP组相比，OSA +睡眠手术组的OR为0.545 （95% CI: 0.480-0.618）。结论：与CPAP组相比，睡眠手术可显著降低OSA患者发生MVAs的风险。在适当的候选者中，应考虑手术以减轻与OSA相关的个人和公共健康风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.