{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T22:19:52Z","timestamp":1794435592587,"version":"4.9.1"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Obstructive sleep apnea (OSA) is a clinically relevant comorbidity in both alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). However, whether its impact differs between these etiologies remains unclear. This study directly compared OSA risk in patients with AFLD and NAFLD to elucidate its role in disease progression. Materials and Methods: We conducted a retrospective cohort study using the TriNetX research network. Adults aged \u2265 20 years with newly diagnosed AFLD or NAFLD between 2006 and 2020 were included. Propensity score matching was applied to balance demographic and clinical covariates. The primary endpoint was incident OSA, assessed at 1-, 2-, 3-, and 5-year intervals, and cumulatively through 28 September 2025. Effect estimates were expressed as relative risk, odds ratio and hazard ratio (HR). Results: Before matching, 896,302 NAFLD and 12,694 AFLD patients were identified; after 1:1 PSM, 11,583 patients remained in each group with balanced baseline characteristics. NAFLD patients consistently demonstrated higher OSA risk. Post-matching, OSA incidence became significantly elevated from year 2 onward (HR at 2 years = 1.764) and persisted at 3 years (HR = 2.078), 5 years (HR = 1.950), and cumulative follow-up (HR = 1.940). Conclusions: NAFLD confers nearly double the long-term OSA risk compared with AFLD. These findings support longitudinal OSA screening and targeted risk reduction strategies in NAFLD populations.<\/jats:p>","DOI":"10.3390\/medicina61122146","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:39:43Z","timestamp":1764679183000},"page":"2146","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Differential Risk of Obstructive Sleep Apnea in Alcoholic Versus Non-Alcoholic Fatty Liver Disease: A Propensity-Matched Cohort Study"],"prefix":"10.3390","volume":"61","author":[{"given":"Ling-Hui","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Respiratory Therapy, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Cheng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Lin Shin Medical Corporation, Lin Shin Hospital, Taichung 408, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Che","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan"},{"name":"Department of Nursing, Min-Hwei Junior College of Health Care Management, Tainan 736, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Yu","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi 600, Taiwan"},{"name":"Department of Artificial Intelligence and Healthcare Management, Central Taiwan University of Science and Technology, Taichung 406, Taiwan"},{"name":"Department of General Education, National Chin-Yi University of Technology, Taichung 411, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Alkhouri, N., Almomani, A., Le, P., Payne, J.Y., Asaad, I., Sakkal, C., Vos, M., Noureddin, M., and Kumar, P. 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