The Effects of Different Types of Sleep Disorder on Colorectal Cancer: A Nationwide Population-Based Cohort Study

SIMPLE SUMMARY: In this study, we used Taiwan’s National Health Insurance Research Database to investigate the potential association between sleep disorder (SD) and colorectal cancer (CRC) after matching 177,707 patients with SD and without a history of CRC with 177,707 non-SD and non-CRC Taiwanese citizens without SD and without CRC based on age and gender. The results demonstrated a significantly higher likelihood of developing CRC in SD patients compared to the control group. Subgroup analysis revealed that among the four different types of SD, the insomnia group exhibited a significantly elevated risk of CRC. It should be noted that individuals simultaneously affected with sleep apnea and insomnia had a significantly higher risk of developing CRC than those with either condition alone. These research findings suggest a potentially higher risk of CRC in Taiwanese SD patients, underscoring the need to explore the relationship between SD and CRC risk. ABSTRACT: The impact of sleep disorders (SDs), particularly sleep apnea (SA), on the development of colorectal cancer (CRC) has been the subject of significant research. However, the potential contribution of other SDs to the incidence of CRC remains unexplored. The objective of this study was to examine the effects of SDs on the risk of developing CRC. This study assessed CRC risk among individuals diagnosed with SDs compared with age- and sex-matched unaffected individuals. A longitudinal, nationwide, population-based cohort study was conducted using data from the Taiwan National Health Insurance Research Database (NHIRD) encompassing 177,707 individuals diagnosed with SDs and 177,707 matched controls. Cox proportional hazard regression analysis was used to determine the relative increased risk of CRC in individuals with SDs and specific subgroups of SDs. The CRC incidences were 1.32-fold higher (95% CI 1.23–1.42) in the overall SD cohort, 1.17-fold higher (95% CI 0.82–1.68) in the SA cohort, 1.42-fold higher (95% CI 1.31–1.55) in the insomnia cohort, 1.27-fold higher (95% CI 1.17–1.38) in the sleep disturbance cohort, and 1.00-fold higher (95% CI 0.77–1.29) in the other SD cohort, after adjusting for age, sex, and comorbidities.