Finnish study gives us a glimpse of OSA’s prevalence and overall comorbidity burden
A new study found that comorbidities are more prevalent in people with obstructive sleep apnea, also known as OSA, as well as discernment into multimorbidity in people who experience incident sleep apnea. The study was published in ERJ Open Research and was done in Finland.
The Finnish Institute for Health and Welfare uses both the Secondary Care Register & the Primary Care Register of Finland as healthcare data repositories. The research study included all patients who were aged 18 and older who received primary care, hospitalization, or outpatient care (secondary care) at a hospital or emergency department in 2017 that had OSA listed under the health-code regulation called the International Classification of Diseases, Tenth Revision code.
At random, each patient that showed conformity of OSA was found to match a control case on the basis of sex, age, district of a hospital, along with binary multimorbidity status. Based on the percentage of adults in Finland with a diagnosis of OSA who attended main or secondary services pertaining to health care between Jan’15 and Dec’19, the prevalence of OSA was calculated.
The patient underwent treatment for several chronic conditions between January 2015 and the time when sleep apnea was diagnosed in 2017. Twenty-six major chronic illness groups were investigated in this research.
166,435 (3.7%) of Finland’s adult population have been diagnosed with OSA in the past five years, while 0.6% (25, 324) have experienced incident sleep apnea in the year 2017.
The OSA patients at the time of diagnosis were primarily male (64.2%), and the average age of the patients was 57.2 years (56.3 years for men and 58.8 years for women). A majority of OSA patients are older (by five years on average), male, and have multiple comorbidities. OSA patients exhibited multimorbidity at a rate of 63%, compared with 38% in the general population.
The most common disease pairings before OSA diagnosis are hypertension and metabolic disorders such as obesity and diabetes. Musculoskeletal diseases and Cardiovascular diseases were also very common. In most cases, arterial hypertension appears first before metabolic disease or obesity is officially diagnosed as multimorbid.
OSA patients were more likely to have four or more comorbidities (34%) than controls or the general population (14%). It was estimated that 52% of females and 36% of males before OSA diagnosis had a musculoskeletal disease. In terms of comorbidities, hypertension is the second most prevalent, followed by cardiovascular disease.
The ratio of odds for obesity is the highest, and dementia is the lowest among OSA patients when compared to matched controls. All health disorder groups, except dementia & related diseases, had greater odds ratios for major chronic diseases than the widespread general population.
Several drawbacks were found in this research. Private health care didn’t feature in this study. The results of the study will likely be skewed since the population of Finland is largely homogenous, with only a small minority of those with non-Caucasian ancestry.
In their research, the researchers did not find a correlation between comorbid conditions and severity, socioeconomic status, symptomatology, or personal lifestyle choices in people with sleep apnea. A home sleep study was required to diagnose OSA because polysomnography was not readily available in the laboratories.
As well as providing insight into multimorbidity in sleep apnea patients, the researchers of their study demonstrated a link between OSA and multimorbidity. According to the researchers, studying the disorders that precede a sleep apnea diagnosis contributes to a much broader understanding of this growing global health concern.