@article {Dodds00057-2020, author = {Sophie Dodds and Linda J. Williams and Amber Roguski and Marjorie Vennelle and Neil J. Douglas and Serafeim-Chrysovalantis Kotoulas and Renata L. Riha}, title = {Mortality and morbidity in obstructive sleep apnoea{\textendash}hypopnoea syndrome: results from a 30-year prospective cohort study}, volume = {6}, number = {3}, elocation-id = {00057-2020}, year = {2020}, doi = {10.1183/23120541.00057-2020}, publisher = {European Respiratory Society}, abstract = {Background Obstructive sleep apnoea{\textendash}hypopnoea syndrome (OSAHS) carries substantial negative health consequences. This study examines factors affecting mortality and morbidity according to continuous positive airway pressure (CPAP) use and predictors affecting CPAP adherence in a longitudinal cohort of OSAHS patients.Materials and methods This prospective, cohort study comprised 4502 patients who were diagnosed with OSAHS at a tertiary sleep disorders centre between 1982 and 2003. Of these, 1174 patients completed follow-up in 2012. Data collected included anthropometric, sleep and demographic characteristics, including comorbidities, ongoing medications and CPAP adherence. Patients were followed up for an average of 14.8{\textpm}3.7 years.Results Imputation analysis showed that long-term CPAP users (\>5 years) were 5.63 times more likely to be alive at study end than non-CPAP users (95\% CI: 4.83{\textendash}6.58, p\<0.001) and 1.74-times more likely than short-term CPAP users (<=5 years) (95\% CI: 1.49{\textendash}2.02, p\<0.001). Females had a significantly higher mortality rate during the follow-up period (26.8\% versus 19.6\%, p\<0.001). Respiratory mortality was more common in patients with OSAHS, in particular those who did not use CPAP, compared to the general population (17.2\% versus 12.2\%, p=0.002 respectively), whereas deaths from cancer were less common compared to the general population (16.2\% versus 25.6\%, p\<0.001). Compared to CPAP users, non-CPAP-users had a significantly increased incidence of type II diabetes mellitus (DMII) (27.9\% versus 18.7\%, p=0.003), ischaemic heart disease (IHD) (25.5\% versus 12.7\%, p\<0.001) and myocardial infarction (MI) (14.7\% versus 4.2\%, p\<0.001) at long-term follow-up.Conclusions Long-term CPAP use in men and women with OSAHS reduces mortality and decreases the incidence of DMII and cardiovascular disease.In this first long-term prospective cohort study to use imputation analysis in OSAHS patients, all-cause morbidity and mortality were significantly reduced in long-term CPAP users (\>5 years), and equivalent for both males and females https://bit.ly/3cKL2HK}, URL = {https://openres.ersjournals.com/content/6/3/00057-2020}, eprint = {https://openres.ersjournals.com/content/6/3/00057-2020.full.pdf}, journal = {ERJ Open Research} }