{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T22:52:48Z","timestamp":1768863168105,"version":"3.49.0"},"reference-count":26,"publisher":"European Respiratory Society (ERS)","issue":"1","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017647","name":"ResMed","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2025,7,4]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Obstructive sleep apnoea (OSA) is a prevalent disorder. No consistent mortality benefit from treating OSA has been reported in randomised controlled trials. This analysis of an age-and-sex-representative anonymised German public health insurance database from 2015\u20132020 investigated mortality and hospitalisation rates in positive airway pressure (PAP)-treated\n                      <jats:italic>versus<\/jats:italic>\n                      non-PAP-treated individuals with OSA, accounting for key confounders, including demographic factors, socioeconomic status, comorbidities and medication use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Treatment-na\u00efve individuals with OSA were selected and stratified by PAP prescription (PAP treated\n                      <jats:italic>versus<\/jats:italic>\n                      non-PAP-treated (controls)). All-cause mortality rates were compared between groups using Cox proportional hazard models, and all-cause hospitalisation rates were compared using 1:1 nearest neighbour matching based on estimated propensity score, age and sex. Group comparisons were made using Chi-squared tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mortality analysis included 12\u2009297 PAP and 10\u2009020 non-PAP-treated individuals. During a mean 4.0\u2005years of follow-up, 1067 people (4.8%) died; the mortality rate was significantly lower in the PAP\n                      <jats:italic>versus<\/jats:italic>\n                      non-PAP group (hazard ratio 0.87, 95% confidence interval (CI) 0.77\u20130.98; p=0.026). The hospitalisation analysis included 8768 PAP-treated individuals and 8768 matched controls. 1926 people (11.0%) were hospitalised; the hospitalisation rate was significantly lower in the PAP\n                      <jats:italic>versus<\/jats:italic>\n                      non-PAP group (odds ratio 0.81, 95% CI 0.74\u20130.89; p&lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this comprehensive analysis, PAP therapy was associated with lower mortality and fewer hospitalisations during the follow-up period compared with no PAP therapy, though residual confounding and the observational nature of the study should be considered when interpreting the results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/23120541.00482-2025","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T14:10:24Z","timestamp":1755785424000},"page":"00482-2025","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of positive airway pressure treatment on mortality and hospitalisation in obstructive sleep apnoea: a German database analysis"],"prefix":"10.1183","volume":"12","author":[{"given":"Holger","family":"Woehrle","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Arzt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7175-5852","authenticated-orcid":false,"given":"Joachim H.","family":"Ficker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melike","family":"Deger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly L.","family":"Sterling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingo","family":"Fietze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Vogelmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Schoebel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"2026011901450497000_12.1.00482-2025.1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6506"},{"key":"2026011901450497000_12.1.00482-2025.2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7640"},{"key":"2026011901450497000_12.1.00482-2025.3","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0200-2021"},{"key":"2026011901450497000_12.1.00482-2025.4","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s11818-023-00435-2","article-title":"Prevalence and predictors of positive airway pressure therapy prescription in obstructive sleep apnoea: a population-representative study","volume":"28","author":"Woehrle","year":"2024","journal-title":"Somnologie"},{"key":"2026011901450497000_12.1.00482-2025.5","doi-asserted-by":"crossref","first-page":"zsab264","DOI":"10.1093\/sleep\/zsab264","article-title":"Continuous positive airway pressure and adverse cardiovascular events in obstructive sleep apnea: are participants of randomized trials representative of sleep clinic patients?","volume":"45","author":"Reynor","year":"2022","journal-title":"Sleep"},{"key":"2026011901450497000_12.1.00482-2025.6","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3895"},{"key":"2026011901450497000_12.1.00482-2025.7","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/S0140-6736(17)31280-1","article-title":"Statutory health insurance in Germany: a health system shaped by 135\u2005years of solidarity, self-governance, and competition","volume":"390","author":"Busse","year":"2017","journal-title":"Lancet"},{"key":"2026011901450497000_12.1.00482-2025.8","doi-asserted-by":"crossref","first-page":"e145","DOI":"10.1055\/s-0042-108647","article-title":"A consensus German reporting standard for secondary data analyses, version 2 (STROSA-STandardisierte BerichtsROutine f\u00fcr Sekund\u00e4rdatenAnalysen)","volume":"78","author":"Swart","year":"2016","journal-title":"Gesundheitswesen"},{"key":"2026011901450497000_12.1.00482-2025.9","first-page":"21","article-title":"The good, the bad, and the ugly: reminders about propensity scores","volume":"3","author":"Strand","year":"2017","journal-title":"Value Outcomes Spotlight"},{"key":"2026011901450497000_12.1.00482-2025.10","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/70.1.41"},{"key":"2026011901450497000_12.1.00482-2025.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-019-00494-6"},{"key":"2026011901450497000_12.1.00482-2025.12","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj149"},{"key":"2026011901450497000_12.1.00482-2025.13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v042.i07","article-title":"Multivariate and propensity score matching software with automated balance optimization: the matching package for R","volume":"42","author":"Sekhon","year":"2011","journal-title":"J Stat Software"},{"key":"2026011901450497000_12.1.00482-2025.14","unstructured":"Team RC . R: A Language and Environment for Statistical Computing. Vienna, Austria. Date last accessed: 13 September 2024. www.R-project.org\/"},{"key":"2026011901450497000_12.1.00482-2025.15","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"2026011901450497000_12.1.00482-2025.16","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202007-888OC"},{"key":"2026011901450497000_12.1.00482-2025.17","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s11818-020-00259-4","article-title":"Low long-term mortality in patients with sleep apnoea and positive airway pressure therapy: analysis of a large German healthcare database","volume":"24","author":"Woehrle","year":"2020","journal-title":"Somnologie"},{"key":"2026011901450497000_12.1.00482-2025.18","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"2026011901450497000_12.1.00482-2025.19","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg115"},{"key":"2026011901450497000_12.1.00482-2025.20","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000864"},{"key":"2026011901450497000_12.1.00482-2025.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.02.013"},{"key":"2026011901450497000_12.1.00482-2025.22","first-page":"e225","article-title":"Impact of positive airway pressure among obstructive sleep apnea patients","volume":"18","author":"Cai","year":"2012","journal-title":"Am J Manag Care"},{"key":"2026011901450497000_12.1.00482-2025.23","doi-asserted-by":"crossref","first-page":"e14099","DOI":"10.1111\/jsr.14099","article-title":"Healthcare resource utilisation and costs in patients with treated obstructive sleep apnea","volume":"33","author":"Sterling","year":"2024","journal-title":"J Sleep Res"},{"key":"2026011901450497000_12.1.00482-2025.24","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1164\/rccm.202109-2035OC","article-title":"Impact of positive airway pressure therapy adherence on outcomes in patients with obstructive sleep apnea and chronic obstructive pulmonary disease","volume":"206","author":"Sterling","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"2026011901450497000_12.1.00482-2025.25","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7912"},{"key":"2026011901450497000_12.1.00482-2025.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2020-000656"}],"container-title":["ERJ Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/23120541.00482-2025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T09:45:15Z","timestamp":1768815915000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/23120541.00482-2025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,21]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,19]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1183\/23120541.00482-2025"],"URL":"https:\/\/doi.org\/10.1183\/23120541.00482-2025","relation":{},"ISSN":["2312-0541"],"issn-type":[{"value":"2312-0541","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,21]]}}}