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Patients with obstructive sleep apnea are at great risk of flavor disorders: a 15-year population-based cohort study

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Abstract

Objective

Obstructive sleep apnea (OSA) results from upper airway remodeling, which has been suggested to alter sensory and motor neuron function due to hypoxia or snore vibration. This study investigated whether OSA was associated with the risk of flavor disorder (FD).

Materials and methods

Seven thousand and eight hundred sixty-five patients with OSA and 7865 propensity score-matched controls without OSA were enrolled between 1999 and 2013 through a nationwide cohort study. The propensity score matching was based on age, sex, comorbidities including hypertension, hyperlipidemia, chronic obstructive pulmonary disease (COPD), asthma, ankylosing spondylitis, and Charlson comorbidity index, and co-medications during the study period, including statins and angiotensin-converting enzyme (ACE) inhibitors. The adjusted hazard ratio (aHR) of incident FD following OSA was derived using a Cox proportional hazard model. A log-rank test was used to evaluate the time-dependent effect of OSA on FD. Age, sex, comorbidities, and co-medications were stratified to identify subgroups susceptible to OSA-associated FD.

Results

Patients with OSA were at a significantly great risk of FD (aHR = 1.91, 95% CI = 1.08–3.38), which was time-dependent (log-rank test p = 0.013). Likewise, patients with hyperlipidemia were at a significant great risk of FD (aHR = 2.99, 95% CI = 1.33–6.69). Subgroup analysis revealed that female patients with OSA were at higher risks of FD (aHR = 2.39, 95%CI = 1.05–5.47).

Conclusions

Patients with OSA were at significantly great risk of incident FD during the 15-year follow-up period, especially in female patients with OSA.

Clinical relevance

Timely interventions for OSA may prevent OSA-associated FD.

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Acknowledgements

The authors thank all their colleagues and students for contributing to this study. We want to thank the two anonymous reviewers and the editors for their comments.

Funding

This study is supported in part by Special research project of Chung Shan Medical University Hospital No. CSH-2018-C-023.CSH-2018-C033. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. * Hsin-Hsin Huang and Kevin Sheng-Kai Ma contributed equally to this work as first authors.

  2. * Chien-Han Tsao and James Cheng-Chung Wei contributed equally as corresponding authors.

Authors and Affiliations

  1. Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Kevin Sheng-Kai Ma

  2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Kevin Sheng-Kai Ma

  3. Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering & Computer Science, National Taiwan University, Taipei, Taiwan

    Kevin Sheng-Kai Ma

  4. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Hsin-Hsin Huang & Min-You Wu

  5. Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Yao-Min Hung

  6. School of Medicine, National Yang Ming University, Taipei, Taiwan

    Yao-Min Hung

  7. Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan

    Chien-Han Tsao & Wei-Sheng Wen

  8. School of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Chien-Han Tsao & James Cheng-Chung Wei

  9. Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan

    James Cheng-Chung Wei

  10. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan

    James Cheng-Chung Wei

  11. Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan

    Yu-Hsun Wang

  12. Chi-Mei Medical Center, Tainan, Taiwan

    Shih-Yen Hung & Max Min Chao

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  1. Hsin-Hsin Huang
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Contributions

This study was supported by Chung Shan Medical University DryLab Team and granted by Chung Shan Medical University Hospital; Kevin Sheng-Kai Ma, Hsin-Hsin Huang, Chien Han Tsao, Shih-Yen Hung, James Cheng-Chung Wei, and Yao-Min Hung conceived and designed the study. James Cheng-Chung Wei provided administrative support. Kevin Sheng-Kai Ma, Chien Han Tsao, Yao-Min Hung, and Yu-Hsun Wang analyzed and interpreted the data. Kevin Sheng-Kai Ma, Hsin-Hsin Huang, Chien Han Tsao, Yao-Min Hung, Wei-Sheng Wen contributed by writing the manuscript. All authors approved the final version of the manuscript to be published.

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Correspondence to Chien-Han Tsao or James Cheng-Chung Wei.

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The study was approved by the institutional review board (IRB) of Chung Shan Medical University (IRB number: CS15134).

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Huang, HH., Ma, K.SK., Wu, MY. et al. Patients with obstructive sleep apnea are at great risk of flavor disorders: a 15-year population-based cohort study. Clin Oral Invest 27, 183–192 (2023). https://doi.org/10.1007/s00784-022-04707-3

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