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Volume 15 No. 09
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Accepted Papers





Scientific Investigations

The Impact of Antidepressants on the Risk of Developing Obstructive Sleep Apnea in Posttraumatic Stress Disorder: A Nationwide Cohort Study in Taiwan

Ching-En Lin, MSc1,2,3; Chi-Hsiang Chung, PhD4,5,6; Li-Fen Chen, MD7; Wu-Chien Chien, PhD3,4,6; Po-Han Chou8,9,10,11
1Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan; 2School of Medicine, Tzu Chi University, Hualien, Taiwan; 3Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan; 4Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 5Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan; 6School of Public Health, National Defense Medical Center, Taipei, Taiwan; 7Department of Psychiatry, Hualien Armed Forces General Hospital, Taiwan; 8Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Taichung, Taiwan; 9Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan; 10Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; 11Biological Optimal Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan

Study Objectives:

The association between posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) has been reported inconsistently, and the association between antidepressant use and the risk of developing OSA in patients with PTSD has not been previously studied. Therefore, we used the Longitudinal National Health Insurance Database (LHID) to investigate the impact of PTSD and antidepressant use on the risk of OSA development.

Methods:

Identified from the LHID, 2,316 individuals aged ≥ 18 years with PTSD, but with no history of OSA, and 23,160 control individuals matched for age, sex, obesity and index date were enrolled between 2000 and 2015 and followed up until the end of 2015 to identify the development of OSA. A two-tailed Bonferroni-corrected P < .00038 (.05/13) was considered statistically significant as we examined 13 antidepressants.

Results:

Individuals with PTSD had increased risk of developing OSA (adjusted hazard ratio 4.672, 95% confidence interval 2.246–9.787, P < .001) after adjusting for demographic data, medical comorbidities, and medication. Treatment with antidepressants was not significantly associated with an increased risk of developing OSA compared to no antidepressant treatment.

Conclusions:

Asian patients with PTSD had increased risk of developing OSA, and treatment with antidepressants did not play a key role in increasing the risk of OSA development. Further studies are required to investigate the underlying mechanisms of PTSD and the roles of antidepressants on the risk of developing OSA.

Citation:

Lin C-E, Chung C-H, Chen L-F, Chien W-C, Chou P-H. The impact of antidepressants on the risk of developing obstructive sleep apnea in posttraumatic stress disorder: a nationwide cohort study in taiwan. J Clin Sleep Med. 2019;15(9):1233–1241.


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