The Impact of Comorbid Sleep-Disordered Breathing on Hospitalization Risk Related to Diabetes and Atherosclerotic Disease: A Retrospective Cohort Analysis

<b>Objective:</b> To determine the relationship between comorbid sleep-disordered breathing (SDB) and hospitalization rates related to diabetes mellitus (DM) and atherosclerotic disease (AD). <b>Methods:</b> This study used a retrospective cohort design from a large medical claims database with 5 years of data between 2018 and 2022. The presences of SDB, DM, and AD were identified using International Classification of Diseases (ICD-10) and relevant Current Procedural Terminology (CPT) codes. Hospitalizations related to DM and AD were identified primarily using Place of Service (POS) code 21. Propensity-score matching was first used on data from the entire 5-year period to select matched controls (unadjusted n = 883,910, adjusted n = 888,619) compared to those diagnosed with SDB (n = 519,818) on hospitalization rates during the concurrent 5-year period. A second analysis used propensity-score matching on data from year 1 only to select matched controls (unadjusted n = 248,848, adjusted n = 260,298) compared to those diagnosed with SDB in year 1 (n = 193,671) on hospitalization outcomes in the subsequent 4-year period. <b>Results</b>: Odds ratios (ORs) revealed a significant association between SDB diagnosis and hospitalizations related to DM (OR 1.23-1.71), AD (OR: 1.08-1.34), and either condition (OR 1.17-1.49) in both analyses. Post hoc analysis revealed sex differences in the relationship between SDB and future hospitalizations, with females showing a pattern of significantly elevated risk across all future hospitalization outcomes (OR: 1.25-1.44), whereas males were found to have a significant relationship between SDB diagnosis and future DM hospitalization only (OR 1.10). <b>Conclusions:</b> These findings provide real-world evidence that comorbid SDB increases the risk for hospitalizations related to chronic cardiometabolic conditions. Sex is a potential moderator of this relationship and should be further explored.