922 - Increasing incidence of obstructive sleep apnea in patients with HIV: A nationwide database analysis

Background: There is an increasing recognition of the burden of chronic non-communicable diseases in patients living with HIV. Fatigue, somnolence and mood symptoms are often reported in this patient population, leading to concern for undiagnosed OSA. We aimed to use the National Inpatient Sample (NIS) to determine incidence of OSA in patients with HIV, and its impact on inpatient outcomes.

Methods: All index admissions reported to the NIS between 2007 and 2016 were included in the analysis. Logistic regression models were used to determine demographic risk factors, as well as comorbid conditions associated with OSA, and the impact of OSA on inpatient outcomes

Results: There was a significant increase in the number of admissions for HIV patients with a comorbid condition of OSA from 766 in 2007 to 3250 in 2016 (p-value < 0.001), corresponding to an annual increase of 15.5%. In patients with OSA, obesity was less often reported in HIV patients (16.0%) vs non-HIV patients (18.6%). HIV-positive patients with OSA had a significant association with hypertension, heart failure, obesity, diabetes, lipodystrophy, renal failure and disorders of pulmonary circulation. OSA was not a risk factor for inpatient mortality. Peak incidence of OSA was reported earlier in females compared to males.

Conclusion: There has been a significant increase in the reported incidence of OSA in patients with HIV, likely representing an increase in awareness of OSA, as well as a true increase in OSA incidence in the post-combination antiretroviral therapy era.