Patients with sleep apnea (SA) are at increased cardiovascular risk. However, little is known about the risk of out-of-hospital cardiac arrest (OHCA) in patients with SA. Therefore, we studied the relation between SA patients who did and did not receive continuous positive airway pressure (CPAP) therapy with OHCA in the general population. Using nationwide databases, we conducted a nested case-control study with OHCA-cases of presumed cardiac causes and age/sex/OHCA-date matched non-OHCA-controls from the general population. Conditional logistic regression models with adjustments for well-known OHCA risk factors were performed to generate odds ratio (OR) of OHCA comparing patients with SA receiving and not receiving CPAP therapy with individuals without SA. We identified 46,578 OHCA-cases and 232,890 matched non-OHCA-controls [mean: 71 years, 68.8% men]. Compared to subjects without SA, having SA without CPAP therapy was associated with increased odds of OHCA after controlling for relevant confounders (OR:1.20, 95%-Cl:1.06–1.36), while having SA with CPAP therapy was not associated with OHCA (OR:1.04, 95%-Cl:0.93–1.36). Regardless of CPAP therapy, age and sex did not significantly influence our findings. Our findings were confirmed in: (I) patients with neither ischemic heart disease nor heart failure (untreated SA, OR:1.24, 95%-CI:1.04–1.47; SA with CPAP, OR:1.08, 95%-CI:0.93–1.25); and (II) in patients without cardiovascular disease (untreated SA, OR:1.33, 95%-CI:1.07–1.65; SA with CPAP, OR:1.14, 95%-CI:0.94–1.39). SA not treated with CPAP was associated with OHCA, while no increased risk of OHCA was found for SA patients treated with CPAP.

中文翻译：

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睡眠呼吸暂停、院外心脏骤停的风险以及持续气道正压通气治疗的潜在益处：一项全国性研究

睡眠呼吸暂停（SA）患者的心血管风险增加。然而，人们对 SA 患者院外心脏骤停 (OHCA) 的风险知之甚少。因此，我们研究了一般人群中接受和未接受持续气道正压通气 (CPAP) 治疗的 SA 患者与 OHCA 之间的关系。利用全国数据库，我们对一般人群中推测的心脏病原因的 OHCA 病例和年龄/性别/OHCA 日期匹配的非 OHCA 对照进行了一项巢式病例对照研究。进行了对众所周知的 OHCA 危险因素进行调整的条件逻辑回归模型，以生成 OHCA 的比值比 (OR)，将接受和未接受 CPAP 治疗的 SA 患者与无 SA 的个体进行比较。我们确定了 46,578 名 OHCA 病例和 232,890 名匹配的非 OHCA 对照[平均年龄：71 岁，68.8% 为男性]。与没有 SA 的受试者相比，在控制相关混杂因素后，没有 CPAP 治疗的 SA 与 OHCA 的几率增加相关（OR：1.20，95%-Cl：1.06–1.36），而 CPAP 治疗的 SA 与 OHCA 无关（OR：1.20，95％-Cl：1.06-1.36）。 OR:1.04, 95%-Cl:0.93–1.36)。无论采用何种 CPAP 治疗，年龄和性别并没有显着影响我们的研究结果。我们的研究结果在以下患者中得到证实：(I)既没有缺血性心脏病也没有心力衰竭的患者（未经治疗的 SA，OR：1.24，95%-CI：1.04–1.47；SA 接受 CPAP，OR：1.08，95%-CI：0.93– 1.25）； (II) 无心血管疾病的患者（未经治疗的 SA，OR：1.33，95%-CI：1.07–1.65；SA 联合 CPAP，OR：1.14，95%-CI：0.94–1.39）。未接受 CPAP 治疗的 SA 与 OHCA 相关，而接受 CPAP 治疗的 SA 患者未发现 OHCA 风险增加。