This Nested Case-Control Study Revealed That Patients With Obesity Experienced More Severe OSA Than Did Those With NASD

Abstract

Objectives: To compare whether nonapnea sleep disorders (NASDs) or obstructive sleep apnea (OSA)are associated with an increased risk of obesity. Methods: From January 1, 2000, to December 31, 2015, we identified 24 363 patients with obesity from the 2005 Longitudinal Health Insurance Database, which is part of Taiwan’s National Health Insurance Research Database; 97 452 patients without obesity were also identified from the same database. The age, sex, and index date were matched. Multiple logistic regression was used to analyze the previous exposure risk of patients with obesity and NASD or OSA. A P value of <.05 was considered significant. Results: Patients with obesity were more likely to be exposed to OSA than did those with NASD (OSA adjusted OR [AOR] = 2.927, 95% CI=1.878-4.194, P < .001; NASD adjusted OR [AOR]=1.693, 95% CI=1.575-1.821, P< .001). Furthermore, the closeness of the exposure period to the index time was positively associated with the severity of obesity, with a dose– response effect (OSA exposure <1 year, AOR=3.895; OSA exposure ≥ 1 year and <5 years, AOR=2.933; OSA exposure ≥5 years, AOR=2.486 ; NASD exposure <1 year, AOR=2.386; NASD exposure ≥1 year and <5 years, AOR=1.725; NASD exposure ≥5 years, AOR=1.422). The exposure duration of OSA in patients with obesity was 2.927 times than that of NASD was 1.693 times. Longer exposure durations were associated with more severe obesity with a dose–response effect (OSA exposure <1 year, AOR = 2.251; OSA exposure ≥1 year and <5 years, AOR=2.986; OSA exposure ≥5 years, AOR=3.452; NASD exposure <1 year, AOR=1.420; NASD exposure ≥1 year and <5 years, AOR=2.240; NASD exposure ≥5 years, AOR=2.863). Conclusions: The risk of obesity was determined to be significantly higher in patients with OSA than that of NASD in this nested case-control study. Longer exposure to OSA or NASD was associated with a higher likelihood of obesity, with a dose-response effect.