People with sleep apnea appear to be at higher risk of pneumonia than people without, according to a study published in CMAJ (Canadian Medical Association Journal).
Sleep apnea is characterized by disrupted sleep, caused when the upper airway becomes obstructed by soft tissue, cutting off oxygen. It has been linked to several types of heart disease and cognitive impairment. People with obstructive sleep apnea are at higher risk of aspiration while sleeping.
To determine whether sleep apnea is linked to the development of pneumonia, Taiwanese researchers followed 34 100 patients (6816 who had sleep apnea and 27 284 controls) for 11 years. They found that pneumonia was more likely to develop in the people with sleep apnea than in the control group (638 [9.36%] v. 2119 [7.77%]). The people with pneumonia were older and had more comorbidities such as heart disease, diabetes, dementia and other diseases.
"This study showed that sleep apnea is an independent risk factor for incident pneumonia," write Dr. Vincent Yi-Fong Su & Dr. Kun-Ta Chou, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, with coauthors. "Our results also demonstrated an exposure-response relation in that patients with more severe sleep apnea may have a higher risk of pneumonia than patients with sleep apnea of milder severity."
Several studies have explored the link between sleep apnea and pneumonia, although they have been smaller than this large cohort study.
The authors suggest that the higher incidence of pneumonia in people with sleep apnea could be because of increased risk of aspirating contents or liquid from the throat.
- Vincent Yi-Fong Su, Chia-Jen Liu, Hsin-Kai Wang, Li-An Wu, Shi-Chuan Chang, Diahn-Warng Perng, Wei-Juin Su, Yuh-Min Chen, Elizabeth Ya-Hsuan Lin, Tzeng-Ji Chen, Kun-Ta Chou. Sleep apnea and risk of pneumonia: a nationwide population-based study. CMAJ, March 2014 DOI: 10.1503/cmaj.131547
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