Obstructive Sleep Apnea is an Independent Risk Factor for Pulmonary Nodules

Abstract Background Although previous studies have suggested a potential connection between OSA and lung cancer, the relationship between OSA and pulmonary nodules remains inadequately explored.Objective: This study aimed to clarify the relationship between OSA and pulmonary nodules. Methods We conducted a cross-sectional study on 303 patients suspected of OSA, using polysomnography (PSG) to assess OSA severity and low-dose chest computed tomography (LDCT) for pulmonary nodule screening. Logistic regression assessed the association between OSA severity and pulmonary nodules. Results A higher proportion of OSA patients had concurrent pulmonary nodules compared to non-OSA patients (P = 0.008). In univariate logistic regression, OSA was significantly associated with pulmonary nodules (OR = 2.506, 95% CI: 1.278–4.914, P = 0.008), and in multivariate analysis, OSA remained independently associated with pulmonary nodules (adjusted OR = 2.240, 95% CI: 1.064–4.718, P = 0.034). OSA patients also had a significantly higher prevalence of ground-glass nodules compared to non-OSA patients (P = 0.006). Univariate logistic regression showed OSA was significantly associated with ground-glass nodules (OR = 5.627, 95% CI: 1.320–23.985, P = 0.020), and in multivariate analysis, OSA remained independently associated with ground-glass nodules (adjusted OR = 5.326, 95% CI: 1.171–24.227, P = 0.030). The severity analysis of OSA showed that moderate-to-severe OSA patients had a 2.4-fold increased risk of pulmonary nodules compared to non-OSA patients and patients with mild OSA had a 2-fold increased risk compared with non-OSA patients(P < 0.05). Conclusion OSA is an independent risk factor for pulmonary nodules, and its severity is associated with increased risk, highlighting the need for early screening in OSA patients.