Age-dependent association between obstructive sleep apnea and self-reported history of fractures: a community-based study.

BACKGROUND: The relationship between obstructive sleep apnea (OSA) and self-reported history of fractures among various age groups in the general population is unclear. METHODS: Participants were recruited using a multistage probability sampling method between 2021 and 2023 in Guangdong Province, China. Sleep study was performed with a wearable type-IV monitor. OSA was defined using the oxygen desaturation index (ODI) of ≥ 5 events/h. Fracture history was self-reported according to physician diagnoses. Poor sleep quality was defined as a Pittsburgh Sleep Quality Index score > 5. RESULTS: A total of 5,519 participants were analyzed. The mean age of participants was 52.7 years. The prevalence rates of OSA and self-reported history of fractures were 44.5% and 13%, respectively. Participants were categorized into groups based on age tertiles. In T3 group (ages 59-91), OSA was significantly associated only with self-reported previous non-traumatic fractures (OR = 3.68, 95%CI:1.79-7.57). Similar results were observed in the T2 group (ages 48-58). OSA was not associated with self-reported history of fractures in the T1 group (ages 18-47). Furthermore, participants with both OSA and poor sleep quality had a higher odds of self-reported previous traumatic fractures compared to those with OSA alone in the T3 group (OR = 1.64, 95% CI:1.02-2.65). Interactions between OSA and age, as well as between OSA and alcohol consumption, regarding self-reported history of fractures were observed (p < 0.05). CONCLUSIONS: OSA was independently associated with self-reported previous non-traumatic fractures in the general population. The association was age-dependent and more meaningful in the elderly population.