The incidence of malignant brain tumors is increased in patients with obstructive sleep apnea: A national health insurance survey

The association between obstructive sleep apnea (OSA) and malignant brain tumors has yet to be fully investigated. Therefore, the purpose of this study was to elucidate the effect of OSA on brain tumor incidence based on the Korea National Health Insurance Service (KNHIS) dataset. The KNHIS data between 2007 and 2014 were analyzed, and the primary endpoint was newly diagnosed malignant brain tumor. A total of 198,574 subjects aged ≥ 20 years with newly diagnosed OSA were enrolled in the study, and 992,870 individuals were selected as a control group based on propensity score matching (PSM) by gender and age. The average follow-up duration was 4.8 ± 2.3 years. The hazard ratios (HRs) for brain tumor for patients with OSA were 1.78 (95% confidence interval [CI]: 1.42–2.21) in Model 1 (not adjusted with any covariate) and 1.67 (95% CI: 1.34–2.09) in Model 2 (adjusted for income level, diabetes, hypertension, dyslipidemia, and COPD). In subgroup analysis by gender, the odds ratios (OR) of OSA were 1.82 (95% CI: 1.41–2.33) in men and 1.26 (95% CI: 0.74–2.03) in women. The ORs were 1.97 (95% CI: 1.15–3.24) in the older (age ≥ 65 years) group, 1.66 (95% CI: 1.25–2.17) in the middle-aged (40 ≤ age < 65 years) group, and 1.41 (0.78–2.44) in the young (20 ≤ age < 40 years) group. In conclusion, OSA may increase the incidence of brain tumors.