Epidemiology of obstructive sleep apnea in a Danish rural population – cross-sectional data from the Lolland-Falster Health Study

PURPOSE: This study examines the prevalence and characteristics of obstructive sleep apnea (OSA) in the general population of a rural-provincial region of Denmark. Additionally, it assesses associations between OSA and various demographic, socioeconomic, and health-related factors. METHODS: This cross-sectional study linked data from the Lolland-Falster Health Study (LOFUS) with nationwide Danish health registries. LOFUS provided data on age, sex, body mass index (BMI), cardiac autonomic neuropathy (CAN), socioeconomic status, smoking, alcohol consumption, snoring, and irregular breathing during sleep from participants recruited between 2016 and 2020. Data on OSA and related chronic comorbidities were obtained from The Danish National Patient Registry and Danish National Prescription Registry. RESULTS: Among 16,138 LOFUS participants, we observed a prevalence of OSA of 2.9%, compared to 2.5% in Lolland-Falster and 2.2% in Denmark. Male sex was associated with OSA (OR = 3.42), as was higher age peaking in the age group 60-79 years old (OR = 6.54) compared to 18-39-year-olds. Age and sex-adjusted estimates showed higher BMI (OR = 2.60 for overweight; OR = 7.67 for obesity), unemployment due to long-term sickness or rehabilitation (OR = 2.70), early retirement due to invalidity (OR = 2.64), divorced/separated/widowed status (OR = 1.89 cohabiting; OR = 1.35 not cohabiting), and former smoking (OR = 1.33) to be significantly associated with OSA. The risk of having OSA was significantly increased if diagnosed with atrial fibrillation and flutter (OR = 2.40), diabetes mellitus (OR = 3.15), essential hypertension (OR = 2.66), or ischemic stroke (OR = 1.82). CONCLUSION: OSA disproportionately affects specific population groups, warranting increased awareness, particularly in patients with OSA-related chronic comorbidities.