BACKGROUND Obstructive sleep apnea (OSA) is typically associated with an increased risk of cardiovascular and cerebrovascular disease. Recent studies, however, have suggested that hypercapnia and chronic intermittent hypoxia may potentially provide protection against ischemic events like stroke. OBJECTIVE To evaluate the impact of OSA with presentation, hospital course, and treatment outcomes of patients with subarachnoid hemorrhage (SAH). METHODS Data for patients with SAH between the years 2011 and 2015 were extracted from the Nationwide Inpatient Sample (NIS) and stratified based on diagnosis codes for OSA. Univariate analysis was used to assess the prevalence of comorbidities in OSA patients diagnosed with SAH and several covariates, including patient demographics, aneurysmal treatment, in-hospital morality rate, length of stay, and costs. Multivariate logistic regression models analyzed the relationship between several comorbidities, including OSA, tobacco use, and hypertension, and poor outcomes after SAH. RESULTS Data from 49 265 SAH patients were used in this study, of which 2408 (4.9%) also had a concomitant OSA diagnosis. Patients with OSA compared to all other SAH patients had a significantly lower in-hospital mortality rate, as well as statistically significant lower odds of vasospasm, stroke, and poor outcomes. Additionally, hypercholesterolemia, obesity, and tobacco use disorder were also associated with more favorable outcomes. CONCLUSION SAH patients with OSA are significantly less likely to have a poor outcome when compared to non-OSA patients, despite having an increased risk of several comorbidities.

中文翻译：

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阻塞性睡眠呼吸暂停对蛛网膜下腔出血后结局的保护作用：一项全国性分析

背景阻塞性睡眠呼吸暂停（OSA）通常与心血管和脑血管疾病的风险增加有关。然而，最近的研究表明，高碳酸血症和慢性间歇性缺氧可能对中风等缺血性事件提供保护。目的 评估 OSA 对蛛网膜下腔出血 (SAH) 患者就诊、住院过程和治疗结果的影响。方法 从全国住院样本 (NIS) 中提取 2011 年至 2015 年间 SAH 患者的数据，并根据 OSA 的诊断代码进行分层。单变量分析用于评估诊断为 SAH 的 OSA 患者合并症的患病率和几个协变量，包括患者人口统计学、动脉瘤治疗、住院死亡率、住院时间和费用。多变量逻辑回归模型分析了几种合并症（包括 OSA、烟草使用和高血压）与 SAH 后不良结局之间的关系。结果 本研究使用了来自 49265 名 SAH 患者的数据，其中 2408 名 (4.9%) 也同时患有 OSA 诊断。与所有其他 SAH 患者相比，OSA 患者的院内死亡率显着降低，血管痉挛、中风和不良预后的几率也显着降低。此外，高胆固醇血症、肥胖和烟草使用障碍也与更有利的结果相关。结论 与非 OSA 患者相比，患有 OSA 的 SAH 患者预后不良的可能性显着降低，尽管几种合并症的风险增加。