S0841 Prevalence of Obstructive Sleep Apnea (OSA) in Patients With and Without Inflammatory Bowel Disease (IBD)

Abstract

INTRODUCTION: The pathogenesis of Obstructive Sleep Apnea (OSA) involves enlargement of the soft tissues of the upper airway, often the result of inflammation. [1] Both Crohn’s Disease (CD) and Ulcerative Colitis (UC), which comprise inflammatory bowel disease (IBD), involve an inflammatory state and can affect extraintestinal sites. [2] This study aims to investigate whether or not IBD patients are at higher risk for the development of OSA. METHODS: This retrospective univariate analysis utilized a commercial database named Explorys (IBM Watson). Utilizing the search tool, we identified patients from 1/2015 to 1/2020 with UC and CD. Cohorts of these patients with and without OSA were then created, utilizing the index event feature to identify patients who were found to have OSA after their diagnosis of IBD, and prevalence values were obtained. Demographic data, as well as data for risk factors for OSA, were also obtained. RESULTS: Baseline characteristics of patients with UC, CD, and without IBD can be seen in Table 1. The rates of OSA in IBD and non-IBD patients, further broken down by age, gender, race, and risk factor can be seen in Table 2. Of the UC cohort, OSA was diagnosed in 9,210, as compared to 10,460 in the CD cohort and 1,745,140 in the non-IBD cohort. As seen in Figure 1, this resulted in an overall prevalence of OSA of 0.078 in UC and 0.072 in CD, as compared to a prevalence of 0.043 in non-IBD patients (OR for UC: 1.9 (95% CI 1.86–1.94, P < 0.0001), OR for CD: 1.72 (95% CI 1.69–1.76, P < 0.0001)). CONCLUSION: This study demonstrates that, on a population level, the prevalence of OSA is significantly higher in both UC and CD, as compared to those without IBD. Extraintestinal inflammation, more specifically inflammation in the airway, is one potential pathophysiologic mechanism for this finding. While this suggests the potential link between the two processes, there are several potential confounding variables, as demonstrated by the variability seen amongst the cohorts both at baseline and amongst the population with OSA. Given these significant limitations in a univariate analysis, in the future, a multivariate analysis will be conducted to correct for the possibility of a spurious association due to another factor.Table 1.: Baseline characteristics of patients with and without inflammatory bowel diseaseTable 2.: Prevalence of obstructive sleep apnea with and without inflammatory bowel disease by age, race, gender, and risk factorFigure 1.: Prevalence of obstructive sleep apnea in patients with and without inflammatory bowel disease.