Patients with obstructive sleep apnea who undergo sleep surgery have a lower incidence of motor vehicle accidents (3.403%) compared to those using continuous positive airway pressure therapy (6.072%), according to a recent study.
Researchers investigated the risk of motor vehicle accidents (MVAs) in patients with obstructive sleep apnea (OSA) undergoing continuous positive airway pressure (CPAP) therapy versus sleep surgery. Researchers conducting the retrospective cohort study utilized the TriNetX national clinical database to analyze a nationwide patient cohort. The study included 2,832,437 patients with OSA, identified using International Classification of Diseases, 10th Revision codes, and categorized them into three groups: those treated with CPAP, those who underwent sleep surgery, and those who received no treatment. Sleep surgeries included uvulopalatopharyngoplasty and hypoglossal nerve stimulation.
Propensity score matching was employed to ensure comparability between cohorts based on age, sex, and race. The incidence of MVAs was analyzed, along with a subanalysis of OSA-related comorbidities as a surrogate for OSA severity.
Patients undergoing sleep surgery had a significantly lower incidence of MVAs (3.403%) compared to the CPAP cohort (6.072%) and the no-treatment group (4.662%), noted first study author Elliott M. Sina, BA, of the Sidney Kimmel Medical College, Thomas Jefferson University, and colleagues. The odds ratio (OR) for MVA incidence in the no-treatment group compared to the sleep surgery cohort was 1.214 (95% confidence interval [CI] = 1.060–1.391, P = .0051), and the OR in the sleep surgery cohort compared to the CPAP cohort was 0.545 (95% CI = 0.480–0.618, P < .0001).
Published in Otolaryngology–Head and Neck Surgery, the study also found that patients with OSA who experienced MVAs were more likely to have comorbidities such as hypertension, diabetes, and heart failure. For instance, 58.8% of patients with OSA who had an MVA had hypertension, compared to 45.4% of those without an MVA (OR = 0.582, 95% CI = 0.577–0.588, P < .0001). Similarly, obesity was present in 42.3% of the MVA group compared to 34.7% without an MVA (OR = 0.725, 95% CI = 0.718–0.731, P < .0001).
The findings suggest that sleep surgery significantly reduces the risk of MVAs in patients with OSA compared to those undergoing either CPAP therapy or no treatment. The authors recommended considering sleep surgery for appropriate candidates to mitigate the personal and public health risks associated with OSA.
Full disclosures can be found in the published study.