Abstract
1297 OSA Is Associated with Increased Incidence of Parkinson’s Disease and Is Mitigated by CPAP Treatment
Sleep (New York, N.Y.), Vol.48(Supplement_1), pp.A558-A559
05/19/2025
DOI: 10.1093/sleep/zsaf090.1297
Abstract
Introduction
Prior work has demonstrated an association between Obstructive Sleep Apnea (OSA) and development of Parkinson’s Disease (PD), but these studies were limited by small sample size, limited duration, confounding by large-effect covariates (e.g. age, race, smoking, comorbidities), and an inaccurate ICD-code-based definition of PD with positive predictive values below 50%. Herein we measure the impact of OSA and OSA treatment on subsequent incidence of PD by using the nationwide records of the US Department of Veterans Affairs, which spans 20+ years, includes 20+ million veterans, allows for adjustment of important covariates, and leverages accurate and validated definitions of PD.
Methods
OSA was defined by ICD-10 code G47.33 (OSA+) along with two validated PD diagnosis case definitions (PPV 76% and 90%). Outcomes included PD and death from any cause. CPAP use was captured in a free-text health record field called the HealthFactor. “CPAP+ Early” was defined as mentions of CPAP within 2 years of OSA diagnosis; “CPAP+ Late” indicated >2 years since OSA diagnosis.
Results
1,552,505 OSA+ and 9,759,246 OSA- Veterans were identified. After weighting analysis and controlling for confounders (balancing of birthyear/age, sex, smoking status, race, ethnicity, pseudo-randomization by covariates, and adjustment for competing risk of death) we found that OSA significantly increased the incidence of PD with 1.8 [1.4, 2.3] 95% CI, p < 0.001) extra cases of PD per 1000 people at 5 years after OSA onset. “CPAP+ Late” had a similar incidence of PD to CPAP-. In contrast, “CPAP+ Early” had lower incidence of PD, with a reduction of 2.3 cases of PD (p < 0.001) 5 years after OSA.
Conclusion
OSA may be a modifiable risk factor for the development of PD and potentially other synucleinopathies. Future work will involve optimizing and validating ascertainment of OSA diagnosis and CPAP usage.
Support (if any)
VA CSRD (CDA2 IK2 CX00253) and VA Portland Health Care System PADRECC. (L.N.) VA BLRD (CDA-2 1 IK2 BX005760), John and Tami Marick Family Foundation, Collins Medical Trust Award, OHSU Medical Research Foundation New Investigator Award, and Oregon Parkinson’s Center Research Pilot Award. (G.D.S.) DoD Parkinson’s Research Program (PD230110). (J.E.E. and M.M.L.)
Details
- Title: Subtitle
- 1297 OSA Is Associated with Increased Incidence of Parkinson’s Disease and Is Mitigated by CPAP Treatment
- Creators
- Jasmine May - Oregon Health and Science University HospitalIsabella Montano - Oregon Health & Science UniversityLee Neilson - VA Portland Health Care SystemYeilim Cho - University of WashingtonJeff Iliff - University of WashingtonJonathan Elliott - VA Portland Health Care SystemGregory Scott - VA Portland Health Care SystemMiranda Lim - Oregon Health & Science University
- Resource Type
- Abstract
- Publication Details
- Sleep (New York, N.Y.), Vol.48(Supplement_1), pp.A558-A559
- DOI
- 10.1093/sleep/zsaf090.1297
- ISSN
- 0161-8105
- eISSN
- 1550-9109
- Publisher
- OXFORD UNIV PRESS INC
- Grant note
- VA CSRD: CDA2 IK2 CX00253 VA Portland Health Care System PADRECCVA BLRD: CDA-2 1 IK2 BX005760 John and Tami Marick Family FoundationCollins Medical Trust AwardOHSU Medical Research Foundation New Investigator AwardOregon Parkinson's Center Research Pilot AwardDoD Parkinson's Research Program: PD230110
VA CSRD (CDA2 IK2 CX00253) and VA Portland Health Care System PADRECC. (L.N.) VA BLRD (CDA-2 1 IK2 BX005760), John and Tami Marick Family Foundation, Collins Medical Trust Award, OHSU Medical Research Foundation New Investigator Award, and Oregon Parkinson's Center Research Pilot Award. (G.D.S.) DoD Parkinson's Research Program (PD230110). (J.E.E. and M.M.L.)
- Language
- English
- Date published
- 05/19/2025
- Academic Unit
- Neurology
- Record Identifier
- 9985089928102771
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