Sleep disorders in individuals without sleep apnea increase the risk of peripheral arterial disorder: a nationwide population-based retrospective cohort study

Sleep Med. 2015 Aug;16(8):966-70. doi: 10.1016/j.sleep.2015.02.538. Epub 2015 Apr 28.


Study objectives: Previous literature lacks the analysis of non-apnea sleep disorder (NASD) and peripheral arterial disease (PAD). The aim of this study was to evaluate the association between NASD and risk of developing PAD using retrospective data from a national database in Taiwan.

Design, setting, and participants: We identified 46,064 patients with NASD using the catastrophic illness registry of the Taiwan National Health Insurance Research Database (NHIRD) from 1996 to 2010. We also selected a comparison cohort of 92,128 subjects who were randomly frequency-matched by age, sex, and entry year of the NASD cohort from the same database.

Interventions: non-apnea sleep disorders.

Main outcome and measurements: The study followed up all subjects from their entry date to the occurrence of PAD. We evaluated the risks of PAD using Cox proportional hazards regression models. The survival function for PAD was assessed using the Kaplan-Meier method.

Results: The risk of PAD was 1.49-fold in patients with NASD compared with patients without NASD after adjusting for age, sex, and comorbidities. Patients with NASD and diabetes or with NASD and hyperlipidemia had an increased risk of PAD compared to those without NASD and diabetes or hyperlipidemia.

Conclusions: We demonstrated the significantly increased risk of PAD in NASD patients through a nationwide population-based retrospective cohort study.

Keywords: Cardiovascular disease; Insomnia; Non-apnea sleep disorder; Peripheral arterial disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Case-Control Studies
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / etiology*
  • Proportional Hazards Models
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Sleep Wake Disorders / complications*
  • Taiwan / epidemiology