The Association between Use of Benzodiazepine Receptor Agonists and the Risk of Obstructive Sleep Apnea: A Nationwide Population-Based Nested Case-Control Study

Tien-Wei Hsu, Hsiu-Min Chen, Tien-Yu Chen, Che-Sheng Chu and Chih-Chuan Pan
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Tien-Wei Hsu: Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
Hsiu-Min Chen: Department of Health-Business Administration, Fooyin University, Kaohsiung 83130, Taiwan
Tien-Yu Chen: Department of Psychiatry, Tri-Service General Hospital, Taipei 11490, Taiwan
Che-Sheng Chu: Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
Chih-Chuan Pan: Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan

IJERPH, 2021, vol. 18, issue 18, 1-12

Abstract: Obstructive sleep apnea (OSA) is characterized by recurrent upper airway collapse. Benzodiazepine receptor agonists (BZRAs) are associated with pharyngeal muscle relaxation, increased apnea duration, and hypoxia, which might worsen OSA. This study aimed to examine the association between the use of BZRAs and the risk of OSA. The study was conducted using data from the National Health Insurance Database of Taiwan between 2002 and 2011. We only included new users who were never exposed to any BZRAs and identified 1848 participants with OSA, and 1848 matched controls. A logistic regression model was used to determine the association between the use of BZRAs and the development of OSA. BZRA exposure was divided into usage patterns, dosage, duration, and pharmacokinetic class. We found an increased risk of OSA in current users and recent past users compared with distant past users. Patients with a higher cumulative dose of BZRAs were more likely to develop OSA compared to those with a lower cumulative dose. We found an increased risk of OSA in patients treated with BZRAs, especially for current users and those with higher cumulative doses. A reduced risk of OSA was found in Z-drug users compared with benzodiazepine users.

Keywords: benzodiazepine receptor agonists; nested case-control study; obstructive sleep apnea; benzodiazepine; Z-drugs (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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