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It is known that if tissue in the pharynx becomes less elastic and robust, it could contribute to obstructive sleep apnea. This paper seeks to investigate whether patients with \u03b1<jats:sub>1<\/jats:sub>-antitrypsin deficiency have an increased risk of sleep apnea.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We tested this hypothesis by doing a nationwide cohort study of 2702 individuals diagnosed with \u03b1<jats:sub>1<\/jats:sub>-antitrypsin deficiency compared with 26,750 individuals without \u03b1<jats:sub>1<\/jats:sub>-antitrypsin deficiency matched on sex, age, and municipality. All individuals were followed from birth and were censored at the time of outcome, emigration, death, or end of follow-up 31st of December 2018, whichever came first.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Individuals with \u03b1<jats:sub>1<\/jats:sub>-antitrypsin deficiency had a higher risk of sleep apnea with an adjusted hazard ratio of 1.81 (95% CI 1.36\u20132.40) compared to controls without \u03b1<jats:sub>1<\/jats:sub>-antitrypsin deficiency. Similarly, the risk of obstructive sleep apnea was nominally higher in individuals with \u03b1<jats:sub>1<\/jats:sub>-antitrypsin deficiency compared to controls without the disease (1.47, 95% CI 0.95\u20132.28). In stratified analysis, the risk of sleep apnea was higher in individuals without chronic obstructive pulmonary disease (2.33, 95% CI 1.54\u20133.51) (P for interaction\u2009&lt;\u20090.05). The increased risk of SA was unaffected when the analysis was stratified by ischemic heart disease, ischemic cerebrovascular disease, type 2 diabetes, hypertension, and liver cirrhosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Individuals with \u03b1<jats:sub>1<\/jats:sub>-antitrypsin deficiency have a higher risk of sleep apnea in the Danish population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00405-025-09270-7","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T19:06:46Z","timestamp":1741979206000},"page":"2679-2686","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Alpha-1 antitrypsin deficiency and risk of sleep apnea: a nationwide cohort study"],"prefix":"10.1007","volume":"282","author":[{"given":"Lucas M\u00f8ller","family":"Larsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sine Voss","family":"Winther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asbj\u00f8rn","family":"K\u00f8rvel-Hanquist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah C. 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Nordestgaard has consultancies with Amarin, Akcea, Amgen, AstraZeneca, Denka Seiken, Kowa, Novartis, Novo Nordisk, and Silence Therap. M. Dahl has consultancies with Grifols, Takeda, and Chiesi. No conflict of interests exists for L.M. Larsen, S.V. Winther, N. Korsb\u00e6k, A. K\u00f8rvel-Hanquist, S.C.W. Marott, E.M. Landt and P. Hom\u00f8e.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Registry-based studies are exempt from approval from an ethics committee and informed consent requirements under Danish legislation. The Copenhagen General Population study was approved by Herlev and Gentofte Hospital and Danish ethics committee (identification number H-KF-01\u2013144\/01) and was conducted according to the declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}