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Patients With Obstructive Sleep Apnea Are Over Four Times More Likely to Suffer From Psoriasis Than the General Population

2018; American Academy of Sleep Medicine; Volume: 14; Issue: 01 Linguagem: Inglês

10.5664/jcsm.6908

1550-9397

Agata Gabryelska, Marcin Sochal, Bartosz Wasik, Piotr Białasiewicz,

Respiratory and Cough-Related Research

Free AccessObstructive Sleep ApneaPatients With Obstructive Sleep Apnea Are Over Four Times More Likely to Suffer From Psoriasis Than the General Population Agata Gabryelska, Marcin Sochal, Bartosz Wasik, Piotr Białasiewicz, MD, PhD Agata Gabryelska Address correspondence to: Agata Gabryelska, Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz+48 660 796 004 E-mail Address: [email protected] Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland , Marcin Sochal Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland , Bartosz Wasik Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland , Piotr Białasiewicz, MD, PhD Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland Published Online:January 15, 2018https://doi.org/10.5664/jcsm.6908Cited by:18SectionsPDF ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutINTRODUCTIONObstructive sleep apnea (OSA) is characterized by recurrent episodes of apneas during sleep, leading to intermittent hypoxemia. The recently reported prevalence reached almost 61% and 84% in women and men, respectively.1 Psoriasis is a chronic inflammatory skin condition, characterized by round, erythematous, dry and scaling patches, accompanied by pain and itching, affecting approximately 2% of Europeans.2 Both OSA and psoriasis are associated with systemic inflammation and activation of inflammatory pathways mediated by OSA may predispose at-risk individuals to the development of psoriasis.3 However, the link between the two disorders is still unclear.In our observational study, we examined 245 consecutive patients who underwent a standard night polysomnography and in whom OSA was diagnosed (apnea-hypopnea index > 5 events/h). The diagnosis of psoriasis was based on patients' history or the presence of the typical enanthem. Within this group we identified 21 who suffered from psoriasis (8.7%).Psoriasis versus no-psoriasis groups were similar regarding age (55.4 ± 11.5 versus 56.8 ± 7.5 years; P = .586), sex (M:F ratio 184:40 versus 18:3; P = .682), body mass index (32.8 ± 5.5 versus 34.2 ± 8.1 kg/m2; P = .308), and apnea-hypopnea index (37.0, 19.5–56.3 versus 35.5, 20.8–59.8; P = .831).The prevalence of psoriasis among patients with OSA in the investigated group was 8.7% compared to a reported prevalence of 2%.2 Thus, the difference in prevalence of psoriasis in patients with OSA and the general population was 6.7% (95% confidence interval, 3.0% to 10.1%).It has recently been shown by Papadavid et al.4 in a similarly sized group that the prevalence of psoriasis in patients with OSA in Greece was 9.5%. This supports our hypothesis that the prevalence of psoriasis in patients with OSA is much higher than in the general population. Therefore, it is important to investigate factors that may increase the risk of psoriasis in patients with OSA (eg, sleep loss leading to exacerbation of psoriasis through immune system modulation).5 Alternatively, obesity rather than OSA may be responsible for increased prevalence of psoriasis in our study group.6Psoriasis itself is associated with sleep problems that partially may be caused by itching and pain.5 However, a possible diagnosis of OSA should be considered while addressing sleeping problems in this particular group, especially if they exhibit high body mass index, which is a strong risk factor for OSA.1DISCLOSURE STATEMENTWork was performed at Sleep and Respiratory Disorders Centre, Medical University of Lodz, Poland. Work was supported by grant 564/1-000-00/564-20-021 from the Medical University of Lodz to AG. All authors have seen and approved the manuscript. The authors report no conflicts of interest.CITATIONGabryelska A, Sochal M, Wasik B, Białasiewicz P. Patients with obstructive sleep apnea are over four times more likely to suffer from psoriasis than the general population. J Clin Sleep Med. 2018;14(1):153.REFERENCES1 Heinzer R, Vat S, Marques-Vidal Pet al.Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med; 2015;34:310-318, 25682233. CrossrefGoogle Scholar2 Boehncke WH, Schön MPPsoriasis. Lancet; 2015;3869997:983-994, 26025581. CrossrefGoogle Scholar3 Yang Y-W, Kang JH, Lin HCIncreased risk of psoriasis following obstructive sleep apnea: A longitudinal population-based study. Sleep Med; 2012;133:285-289, 22285106. CrossrefGoogle Scholar4 Papadavid E, Dalamaga M, Vlami Ket al.Psoriasis is associated with risk of obstructive sleep apnea independently from metabolic parameters and other comorbidities: a large hospital-based case-control study. Sleep Breath; 2017;328Suppl 2:1230-1210. 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The effectiveness of mandibular advancement devices in the treatment of obstructive sleep apnoea in adults: a methodological quality assessment of systematic reviewsIncerti Parenti S, Aroni E, Laffranchi L, Paganelli C and Alessandri-Bonetti G European Journal of Orthodontics, 10.1093/ejo/cjz065, IL-33 Mediated Inflammation in Chronic Respiratory Diseases—Understanding the Role of the Member of IL-1 SuperfamilyGabryelska A, Kuna P, Antczak A, Białasiewicz P and Panek M Frontiers in Immunology, 10.3389/fimmu.2019.00692, Vol. 10, Obstructive Sleep Apnea: From Intermittent Hypoxia to Cardiovascular Complications via Blood PlateletsGabryelska A, Łukasik Z, Makowska J and Białasiewicz P Frontiers in Neurology, 10.3389/fneur.2018.00635, Vol. 9, Is Autonomic Activation a Middleman Between Obstructive Sleep Apnea Syndrome and Psoriasis?Gabryelska A and Białasiewicz P Journal of Clinical Sleep Medicine, Vol. 14, No. 06, (1087-1088), Online publication date: 15-Jun-2018.Psoriasis Is Associated With a Higher Prevalence of Obstructive Sleep Apnea and Restless Legs Syndrome: A Possible Indication of Autonomic Activation in PsoriasisGupta M and Gupta A Journal of Clinical Sleep Medicine, Vol. 14, No. 06, (1085-1085), Online publication date: 15-Jun-2018. Volume 14 • Issue 01 • January 15, 2018ISSN (print): 1550-9389ISSN (online): 1550-9397Frequency: Monthly Metrics History Submitted for publicationOctober 4, 2017Submitted in final revised formOctober 4, 2017Accepted for publicationOctober 11, 2017Published onlineJanuary 15, 2018 Information© 2018 American Academy of Sleep MedicinePDF download