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Monthly Archives: October 2012

Obstructive sleep apnea and multimorbidity

By Laurence Robichaud-Hallé

A paper entitled Obstructive sleep apnea and multimorbidity was recently published in BMC Pulmonary Medicine. The work described was carried out in the course of completing a Master’s degree in Clinical Sciences at the Université de Sherbrooke, Quebec, Canada, under the supervision of Dr. Martin Fortin and Dr. Michel Beaudry. Obstructive sleep apnea (OSA) poses a major public health problem due to its prevalence, severity and socioeconomic burden. According to the Public Health Agency of Canada, 858,900 Canadians reported suffering from sleep apnea, and almost 26% of Canadians are at high risk of developing the condition (http://www.phac-aspc.gc.ca/cd-mc/sleepapnea-apneesommeil/ff-rr-2009-eng.php).

Multimorbidity—defined as the co-occurrence of two or more chronic diseases—is highly prevalent in primary care. One study reported that multimorbidity is observed in patients with OSA (1), but, to our knowledge, ours is the first to analyse the association between OSA and multimorbidity.

Our study revealed an association between severe OSA and severity of multimorbidity as measured by the Disease Burden Morbidity Assessment (DBMA) (2). The relationship was still present after adjusting for several potential confounders. The study also showed an association between OSA and multimorbidity sub-scores (cardiac, vascular, metabolic syndrome).

Primary care providers should be aware of these potential associations and investigate OSA when deemed appropriate.

This research received financial support from the CIHR Applied Research Chair – Health Services and Policy Research on Chronic Diseases in Primary Care/Canadian Institutes of Health Research-Institute of Health Services and Policy Research, Canadian Health Services Research Foundation and Centre de santé et de services sociaux de Chicoutimi.


1)     Smith R, Ronald J, Delaive K, Walld R, Manfreda J, Kryger M: What are obstructive sleep apnea patients being treated for prior to this diagnosis? Chest 2002, 121:164–172.

2)     Poitras M-E, Fortin M, Hudon C, Haggerty J, Almirall J: Validation of the disease burden morbidity assessment by self-report in a French-speaking population. BMC Health Service Research 2012, 12:35.

Publications on multimorbidity May – August 2012

By Martin Fortin

Since last year, I have been sharing with you blog visitors the results of literature searches for the latest published papers on multimorbidity that we do on a regular basis. Many new papers on multimorbidity have been published during the May-August period of this year. Usually, the titles of all publications are listed here in the post. However, this time the number of publications in the list is too long for this venue so instead of listing the publications here, a pdf document including the publications has been prepared and can be accessed following this link.

All references are also included in our library. Feel free to share with anyone interested in multimorbidity.

It is nice to note that an important body of information covering different aspects of the subject is growing each year. To provide an idea of the increase of the number of publications on multimorbidity we did a simple search in Medline using the word multimorbidity. Articles published in any language were considered. The graph below shows how the number of publications at least mentioning multimorbidity has increased since the year 2000.

It looks like the many challenges of multimorbidity are attracting more researchers on the subject.