Temporal trends in mortality from pneumonia and obstructive sleep apnea in the United States (1999–2020): Insights from CDC WONDER

Pneumonia is a significant cause of mortality in the United States. In the same way, obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder that can disrupt the normal respiratory function through intermittent hypoxia, systemic inflammation, and impaired airway clearance. Data suggest that OSA may increase the chances of having pneumonia and can make the outcomes worse. To describe temporal trends and demographic patterns in mortality among US adults with pneumonia and coexisting OSA from 1999 to 2020. We performed a retrospective analysis by population using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research multiple-cause-of-death database from 1999 to 2020. Pneumonia deaths were identified by International Classification of Diseases, Tenth Revision codes J09-J18, and OSA by International Classification of Diseases, Tenth Revision code G47.3. We have calculated age-adjusted mortality rates (AAMR) per 100,000 population. Joinpoint Regression Software was used to estimate annual percent change and average annual percent change with confidence intervals of 95%. This study complies with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A total of 13,496 deaths from pneumonia and OSA in US adults aged ≥ 25 were identified during this study period-males exhibited higher mortality than females (AAMR: 0.38 vs 0.21). The total deaths in males were 8046, consisting 59.63% of the overall total deaths, while total deaths in females were 5450, consisting 40.38% of the overall total deaths. The AAMR rose from 0.09 in 1999 to 0.86 in 2020 (average annual percent change: 7.3307%, 95% confidence interval: 3.93-10.84). Between 1999 and 2020, mortality related to pneumonia among the patients with OSA increased significantly in the US, with significant demographic and geographic variations. There was a significant increase in death in male population 2018 onwards. These findings emphasize the need for better screening and management of OSA in populations that are at risk for pneumonia.