Increased risk of obstructive sleep apnoea in women with polycystic ovary syndrome: a population-based cohort study
File(s)
Published version
Author(s)
Kumarendran, Balachandran
Sumilo, Dana
O'Reilly, Michael W
Toulis, Konstantinos A
Gokhale, Krishna M
Type
Journal Article
Abstract
Objective
Obesity is very common in patients with obstructive sleep apnoea (OSA) and polycystic ovary syndrome (PCOS). Longitudinal studies assessing OSA risk in PCOS and examining the role of obesity are lacking. Our objective was to assess the risk of OSA in women with vs without PCOS and to examine the role of obesity in the observed findings.
Design
Population-based retrospective cohort study utilizing The Health Improvement Network (THIN), UK.
Methods
76 978 women with PCOS and 143 077 age-, BMI- and location-matched women without PCOS between January 2000 and May 2017 were identified. Hazard ratio (HR) for OSA among women with and without PCOS were calculated after controlling for confounding variables using multivariate Cox models.
Results
Median patient age was 30 (IQR: 25–35) years; median follow-up was 3.5 (IQR: 1.4–7.1) years. We found 298 OSA cases in PCOS women vs 222 in controls, with incidence rates for OSA of 8.1 and 3.3 per 10 000 person years, respectively. Women with PCOS were at increased risk of developing OSA (adjusted HR = 2.26, 95% CI: 1.89–2.69, P < 0.001), with similar HRs for normal weight, overweight and obese PCOS women.
Conclusions
Women with PCOS are at increased risk of developing OSA compared to control women irrespective of obesity. Considering the significant metabolic morbidity associated with OSA, clinicians should have a low threshold to test for OSA in women with PCOS. Whether OSA treatment has an impact on PCOS symptoms and outcomes needs to be examined.
Obesity is very common in patients with obstructive sleep apnoea (OSA) and polycystic ovary syndrome (PCOS). Longitudinal studies assessing OSA risk in PCOS and examining the role of obesity are lacking. Our objective was to assess the risk of OSA in women with vs without PCOS and to examine the role of obesity in the observed findings.
Design
Population-based retrospective cohort study utilizing The Health Improvement Network (THIN), UK.
Methods
76 978 women with PCOS and 143 077 age-, BMI- and location-matched women without PCOS between January 2000 and May 2017 were identified. Hazard ratio (HR) for OSA among women with and without PCOS were calculated after controlling for confounding variables using multivariate Cox models.
Results
Median patient age was 30 (IQR: 25–35) years; median follow-up was 3.5 (IQR: 1.4–7.1) years. We found 298 OSA cases in PCOS women vs 222 in controls, with incidence rates for OSA of 8.1 and 3.3 per 10 000 person years, respectively. Women with PCOS were at increased risk of developing OSA (adjusted HR = 2.26, 95% CI: 1.89–2.69, P < 0.001), with similar HRs for normal weight, overweight and obese PCOS women.
Conclusions
Women with PCOS are at increased risk of developing OSA compared to control women irrespective of obesity. Considering the significant metabolic morbidity associated with OSA, clinicians should have a low threshold to test for OSA in women with PCOS. Whether OSA treatment has an impact on PCOS symptoms and outcomes needs to be examined.
Date Issued
2019-04-01
Date Acceptance
2019-02-13
Citation
European Journal of Endocrinology (EJE), 2019, 180 (4), pp.265-272
ISSN
0804-4643
Publisher
Oxford University Press
Start Page
265
End Page
272
Journal / Book Title
European Journal of Endocrinology (EJE)
Volume
180
Issue
4
Copyright Statement
© 2019 The authors Published by Bioscientifica Ltd This work is licensed under a Creative Commons Attribution 4.0 International License.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30763274
PII: EJE-18-0693
Subjects
ALL-CAUSE MORTALITY
CARDIOVASCULAR-DISEASE
Endocrinology & Metabolism
HORMONES
Life Sciences & Biomedicine
METAANALYSIS
METABOLIC DYSFUNCTION
Science & Technology
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2019-04-01