Multimorbidity and overall comorbidity of sleep apnoea: a Finnish nationwide study.

The prevalence of sleep apnoea is increasing globally; however, population-based studies have reported a wide variation of prevalence estimates, and data on incidence of clinically diagnosed sleep apnoea are scant. Data on the overall burden of comorbidities or multimorbidity in individuals with incident sleep apnoea are scarce, and the pathways to multimorbidity have only marginally been studied. To study the current epidemiology of sleep apnoea in Finland, overall burden of comorbidities, and multimorbidity profiles in individuals with incident sleep apnoea, we conducted a register-based, nationwide, retrospective study of data from January 2016 to December 2019. The prevalence of clinically diagnosed sleep apnoea was 3.7% in the Finnish adult population; 1-year incidence was 0.6%. Multimorbidity was present in 63% of individuals at the time of sleep apnoea diagnosis. Of those with incident sleep apnoea, 34% were heavily multimorbid (presenting with four or more comorbidities). The three most common chronic morbidities before sleep apnoea diagnosis were musculoskeletal disease, hypertension and cardiovascular disease. In multimorbid sleep apnoea patients, hypertension and metabolic diseases including obesity and diabetes, cardiovascular diseases, musculoskeletal diseases and dorsopathies, in different combinations, encompassed the most frequent disease pairs preceding a sleep apnoea diagnosis. Our study adds to the few population-based studies by introducing overall and detailed figures on the burden of comorbidities in sleep apnoea in a nationwide sample and provides up-to-date information on the occurrence of sleep apnoea as well as novel insights into multimorbidity in individuals with incident sleep apnoea.

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Conflict of interest: M. Palomäki has received lecture fees from GlaxoSmithCline Ltd, Chiesi Ltd and Orion Ltd, and research grants from the Foundation of the Finnish Anti-Tuberculosis Association, Väinö and Laina Kivi Foundation, and Ida Montin Foundation. Conflict of interest: T. Saaresranta is the chairperson of the Finnish Task Force for Current Care Guidelines of Adult Sleep Apnoea. She has received lecture fees from Jazz Pharmaceuticals and financial support for educational events from ResMed Finland and Philips Healthcare Finland. Conflict of interest: U. Anttalainen has received research grants from the Finnish Government/Turku University Hospital the, Foundation of the Finnish Anti-Tuberculosis Association, the Tampere Tuberculosis Foundation and the Research Foundation for Respiratory Diseases. Conflict of interest: M. Partinen has received a study grant from the Parkinson Foundation, consulting fees from Jazz Pharmaceuticals and Bioprojet, and lecturing fees from MSD, Takeda and GSK, and has participated in the medical advisory board of Jazz Pharmaceuticals and Bioprojet. Conflict of interest: J. Keto is an employee of Jazz Pharmaceuticals. Conflict of interest: M. Linna has received consulting fees from Jazz Pharmaceuticals.