PMID- 32013932 OWN - NLM STAT- MEDLINE DCOM- 20201127 LR - 20201127 IS - 1471-2466 (Electronic) IS - 1471-2466 (Linking) VI - 20 IP - 1 DP - 2020 Feb 3 TI - Stimulants associated with reduced risk of hospitalization for motor vehicle accident injury in patients with obstructive sleep apnea-a nationwide cohort study. PG - 28 LID - 10.1186/s12890-019-1041-1 [doi] LID - 28 AB - BACKGROUND: The risk of injury directly related to hospitalization for motor vehicle accidents (MVAs) in the obstructive sleep apnea (OSA) patients has not been thoroughly understood. Our study aimed to examine the association between the OSA and the hospitalization for an MVA injury. METHODS: This retrospective cohort study used Taiwan's National Health Insurance Research Database (NHIRD) between 2000 and 2015. The OSA patients aged >/=20 years by age, sex, and index-year matched by non-OSA controls were enrolled (1:3). We used the Cox proportional regression model to evaluate the association between the OSA and the hospitalization for an MVA injury. RESULTS: The incidence rate of hospitalization for an MVA injury was higher in the OSA cohort (N = 3025) when compared with the non-OSA controls (N = 9075), as 575.3 and 372.0 per 100,000 person-years, respectively (p < 0.001). The Kaplan-Meier analysis showed that the OSA cohort had a significantly higher incidence of hospitalization for the MVA injury (log-rank test, p < 0.001). After adjusting for the covariates, the risk of hospitalization for the MVA injury among the OSA was significantly higher (hazard ratio [HR] =2.18; 95% confidence interval [CI] = 1.79-2.64; p < 0.001). Stimulants usage was associated with a nearly 20% decrease in the risk of an overall hospitalization for an MVA injury in the OSA patients. CONCLUSIONS: This study provides evidence that patients with OSA are at a two-fold higher risk of developing hospitalization for an MVA injury, and the usage of modafinil and methylphenidate was associated with a lower risk of an overall hospitalization for the MVA injury. FAU - Lin, Yi-Chang AU - Lin YC AD - Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. AD - Department of Biological Science and Technology, National Chiao Tung University, No.75, Po-Ai Street, Hsinchu, 30068, Taiwan. FAU - Chen, Tien-Yu AU - Chen TY AD - Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan. AD - Department of Psychiatry, Tri-Service General Hospital, Keelung Branch, National Defense Medical Center, Taipei, Taiwan. FAU - Chien, Wu-Chien AU - Chien WC AD - Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. AD - School of Public Health, National Defense Medical Center, Taipei, Taiwan. AD - Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan. FAU - Chung, Chi-Hsiang AU - Chung CH AD - Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. AD - School of Public Health, National Defense Medical Center, Taipei, Taiwan. AD - Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan. FAU - Chang, Hsin-An AU - Chang HA AD - Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan. AD - Student Counseling Center, National Defense Medical Center, Taipei, Taiwan. FAU - Kao, Yu-Chen AU - Kao YC AD - Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan. AD - Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan. FAU - Tsai, Chien-Sung AU - Tsai CS AD - Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. FAU - Lin, Chih-Sheng AU - Lin CS AD - Department of Biological Science and Technology, National Chiao Tung University, No.75, Po-Ai Street, Hsinchu, 30068, Taiwan. lincs@mail.nctu.edu.tw. FAU - Tzeng, Nian-Shen AU - Tzeng NS AUID- ORCID: 0000-0001-5881-7089 AD - Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan. pierrens@mail.ndmctsgh.edu.tw. AD - Student Counseling Center, National Defense Medical Center, Taipei, Taiwan. pierrens@mail.ndmctsgh.edu.tw. LA - eng GR - MAB-107-084/Ministry of National Defense/ GR - TSGH-C106-106/Tri-Service General Hospital/ GR - TSGH-C107-004/Tri-Service General Hospital/ GR - TSGH-C107-106/Tri-Service General Hospital/ GR - TSGH-C108-027/Tri-Service General Hospital/ GR - TSGH-C108-151/Tri-Service General Hospital/ GR - TSGH-C108-003/Tri-Service General Hospital/ PT - Journal Article DEP - 20200203 PL - England TA - BMC Pulm Med JT - BMC pulmonary medicine JID - 100968563 RN - 0 (Central Nervous System Stimulants) RN - 207ZZ9QZ49 (Methylphenidate) RN - R3UK8X3U3D (Modafinil) SB - IM MH - Accidents, Traffic/*prevention & control/*statistics & numerical data MH - Adult MH - Aged MH - Central Nervous System Stimulants/*therapeutic use MH - Databases, Factual MH - Female MH - Hospitalization/*trends MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Methylphenidate/therapeutic use MH - Middle Aged MH - Modafinil/therapeutic use MH - Motor Vehicles MH - Proportional Hazards Models MH - Retrospective Studies MH - Risk Factors MH - Sleep Apnea, Obstructive/*drug therapy/epidemiology MH - Taiwan/epidemiology MH - Young Adult PMC - PMC6998364 OTO - NOTNLM OT - Cohort study OT - Longitudinal health insurance database OT - Motor vehicle accident injury OT - National Health Insurance Research Database OT - Obstructive sleep apnea COIS- The authors declare that they have no competing interests. EDAT- 2020/02/06 06:00 MHDA- 2020/11/28 06:00 PMCR- 2020/02/03 CRDT- 2020/02/05 06:00 PHST- 2019/02/11 00:00 [received] PHST- 2019/12/24 00:00 [accepted] PHST- 2020/02/05 06:00 [entrez] PHST- 2020/02/06 06:00 [pubmed] PHST- 2020/11/28 06:00 [medline] PHST- 2020/02/03 00:00 [pmc-release] AID - 10.1186/s12890-019-1041-1 [pii] AID - 1041 [pii] AID - 10.1186/s12890-019-1041-1 [doi] PST - epublish SO - BMC Pulm Med. 2020 Feb 3;20(1):28. doi: 10.1186/s12890-019-1041-1.