| Description: |
Sleep apnea-related intermittent hypoxia and the chronic inflammation of arthritis share oxidative-stress pathways, yet their epidemiologic overlap remains under-described. The prevalence of both conditions increases with age and presents unique challenges for patient management. To quantify the association between clinician-suspected arthritis and self-reported sleep apnea and to explore whether demographic or cognitive factors modify that link. We analyzed 17,013 adults enrolled in the referral-based National Alzheimer Coordinating Center Uniform Data Set, version 3. Complete-case binary logistic regression modeled obstructive sleep apnea (OSA) (yes/no) on arthritis (yes/no) with adjustment for age, sex, race (White vs non-White), years of education, cognitive status (normal, mild cognitive impairment, Alzheimer disease), body mass index, and cardiometabolic comorbidities. A pre-specified interaction term tested whether cognition modified the arthritis–OSA association. Multiple imputation was used to address missing data. Arthritis was associated with 60% higher odds of OSA (adjusted odds ratio = 1.60, 95% confidence interval: 1.46–1.76, P < .001). The effect was attenuated in Alzheimer disease. Male sex, atrial fibrillation, stroke, diabetes, and higher body mass index were additional correlates (all P < .001); age was not independently significant. Imputation yielded similar estimates. Clinician-suspected arthritis was robustly associated with self-reported OSA even after extensive adjustment, although unmeasured confounding and exposure misclassification cannot be excluded. Both OSA and arthritis were ascertained by self-report or single-clinician designation without polysomnography, actigraphy, imaging, or serology, raising non-differential misclassification potential. The cross-sectional design prevents causal interpretation, and the predominantly White, highly educated volunteer cohort limits generalizability. Prospective, objectively phenotyped studies, ideally with arthritis sub-typing, are ... |