Sleep apnoea patients have higher mortality when confronting sepsis

Background: Sleep is essential for the maintenance of an intact immune function. Patients with sleep apnoea experience frequent sleep interruption due to apnoea-related arousals, possibly adversely impacting their immunity and affecting their outcomes when confronting sepsis. This case-control study aimed to compare the outcomes of sepsis patients with and without sleep apnoea. Methods: From 2000 to 2009, 168 sleep apnoea patients who were first admitted for sepsis were identified from the Taiwan National Health Insurance Research Database. Also, 672 sepsis patients without sleep apnoea, who were matched by age, gender and Charlson's comorbidity index scores, served as controls. Hospital outcomes of the two groups were compared. Binary logistic regression was employed for multivariate analysis. Results: The mortality rates of sepsis patients with and without sleep apnoea were 60·1% and 47·9%, respectively (P = 0·005). After multivariate adjustment, sleep apnoea (OR: 1·805, 95% CI: 1·227-2·656, P = 0·003), presence of shock (OR: 3·600, 95% CI: 2·144-6·046, P < 0·001) and number of organs with dysfunction (OR: 1·591, 95% CI: 1·087-2·329, P = 0·017) were found to be independently associated with mortality. Sleep apnoea patients who needed continuous positive airway pressure treatment had an even higher risk of mortality. Conclusions: Sepsis patients with sleep apnoea may have poorer hospital outcomes than those without sleep apnoea.