Non-apnea sleep disorder and its risk for all kinds of injuries

Abstract

Non-apnea sleep disorder (NASD) increases the risk of motor vehicle accidents. However, systemic review of NASD and its risk for all causes of injury is lacking. The aim of the present study was to provide a detailed demographic data on NASD and all causes of injury in a 14-year follow up. Our study utilized outpatient and inpatient data from the Longitudinal Health Insurance Database between 2000 and 2013 in Taiwan. We enrolled 989,753 individuals aged ≥20 years who were diagnosed with NASD as outpatients ≥3 times or inpatients ≥1 time. We matched the study cohort with a comparison cohort by age, index date and comorbidities at a ratio of 1:4. We used Cox proportional hazards regression to analyze the association of NASD and the cause of injury. In this 14-year follow up study, patients with NASD had 12.96% increased risk of injury compared to that of the control cohort. Fall was the first place of the cause of injury with 670.26 per 105 PYs. In the stratified age group, patients aged ≧65 years had the highest risk of injury (adjusted HR= 1.381; P < .001). Kaplan–Meier analysis showed that the incidence of injury between the with- and without-NASD cohorts started from the first year and persisted until the end of the follow-up. Our study demonstrates that NASD patients were associated with higher risk of all causes of injuries, with falling being the most prevalent diagnosis. The general public should be more aware of this neglected issue of NASD.

Sleep and the Fitness to Drive: A Swiss Perspective

“…In the clinical setting, two of the most commonly encountered causes leading to EDS are obstructive sleep apnea, restless leg syndrome and periodic limb movement disorder [41]. Other reports count non-apnea sleep disorders higher in risk, but for all injuries, not limited to driving [50]. At the same time, several reports [51] indicate, that also sleep medication-or sleep medication-withdrawalinduced psychomotor impairments/disorders, such as REM-sleep behavior disorder, RBD, might lead to parasomnias and, in consequence, EDS [42].…”