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Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients

Year 2019, Volume: 21 Issue: 2, 127 - 131, 30.08.2019
https://doi.org/10.18678/dtfd.560477

Abstract

Aim: Psoriasis is a frequently seen chronic systemic inflammatory disease accompanied by several comorbid conditions that affects 2-3% of the general population. One of the comorbidities rarely accompanying psoriasis is obstructive sleep apnea syndrome (OSAS). OSAS is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper airway obstruction episodes and frequently by decreased blood oxygen saturation. The purpose of this study was to evaluate the risk factors for OSAS by investigating OSAS symptoms in psoriasis patients.

Material and Methods: Eighty-two patients aged over 16, diagnosed with psoriasis, and under follow-up by the Duzce University Medical of Faculty, Dermatology and Venereal Diseases Polyclinic, Turkey, were included in the study. Patients’ OSAS symptoms were investigated. The Epworth Sleepiness Scale was used to assess excessive daytime somnolence.

Results: Of the patients 51.2% (n=42) were male and 48.8% (n=40) female. Patients’ mean age was 47.09±14.10 years. Patients’ mean time of psoriasis diagnosis was 16.97±10.55 years, and mean Psoriatic Area Severity Index (PASI) score was 11.25±6.32. Severe disease was present in 54.9% of patients (n=45) based on PASI classification. Prevalence of 56.1% for snoring, 25.6% for excessive daytime sleepiness, and 15.9% for witnessed apnea were determined in these patients. Forty-seven (57.3%) cases had at least one major symptom. The most common minor symptoms were inability to sleep with 25.6% (n=21) and insufficient disrupted sleep with 22.0% (n=18).

Conclusion: Prevalence of OSAS symptoms in psoriasis patients were found high. Psoriasis patients with OSAS symptoms must be referred to relevant specialists for polysomnographic evaluation.

References

  • Grozdev I, Korman N, Tsankov N. Psoriazis as a systemic disease. Clin Dermatol. 2014;32(3):343-50.
  • Kalkan G. Comorbidities in psoriasis: The recognition of psoriasis as a systemic disease and current management. Turkderm-Turk Arch Dermatol Venereolgy. 2017;51(3):71-7.
  • American Academy of Sleep Medicine. International Classification of sleep disorders: diagnostic and coding manual (ICSD-2). 2nd ed. Westchester, IL: American Academy of Sleep Medicine; 2005.
  • Rowley JA. Excessive daytime sleppiness: medicolegal aspects. In: Atwood CW, Phillips BA, editors. ACCP sleep medicine board review course syllabus 2007. Northbrook, IL: American College of Chest Physicians; 2007. p.177-83.
  • Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-5.
  • Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, et al. Psoriazis and comorbid diseases: epidemiology. J Am Acad Dermatol. 2017;76(3):377-90.
  • Gürer MA. Introduction to psoriasis. Turkderm-Turk Arch Dermatol Venereolgy. 2016;50(Suppl 1):2-3.
  • Machado-Pinto J, Diniz Mdos S, Bavoso NC. Psoriazis: new comorbidities. An Bras Dermatol. 2016; 91(1):8-14.
  • Oliveira Mde F, Rocha Bde O, Duarte GV. Psoriazis: classical and emerging comorbidities. An Bras Dermatol. 2015;90(1):9-20.
  • Wang F, Xiong X, Xu H, Huang H, Shi Y, Li X, et al. The association between obstructive sleep apnea syndrome and metabolic syndrome: a confirmatory factor analysis. Sleep Breath. 2019;23(3):1011-9.
  • Ljunggren M, Lindberg E, Franklin KA, Öhagen P, Larsson M, Theorell-Haglöw J, et al. Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women. Sleep. 2018;41(7):1-8.
  • Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-5.
  • Seneviratne U, Puvanendran K. Excessive day time sleepiness in obstructive sleep apnea: prevalence, severity, and predictors. Sleep Med. 2004;5(4):339-43.
  • Young T, Hutton R, Finn L, Badr S, Palta M. The gender bias in sleep apnea diagnosis. Are women missed because they have different symptoms? Arch Intern Med. 1996;156(21):2445-51.
  • Dursunoğlu N, Dursunoğlu D. Obstructive sleep apnea syndrome and cardiovascular complications. Updates on Pulmonary Diseases. 2014;2(2):159-69.
  • Lavie L. Obstructive sleep apnoea syndrome-an oxidative stres disorder. Sleep Med Rev. 2003;7(1):35-51.
  • Prodanovich S, Kirsner RS, Kravetz JD, Ma F, Martinez L, Federman DG. Association of psoriasis with coronary artery, cerebrovascular, and peripheral vascular diseases and mortality. Arch Dermatol. 2009;145(6):700-3.
  • Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296(14):1735-41.
  • Karaca S, Fidan F, Erkan F, Nural S, Pinarcı T, Gunay E, et al. Might psoriazis be a risk factor for obstructive sleep apnea syndrome? Sleep Breath. 2013;17(1):275-80.
  • Şereflican B, Kar Kurt Ö, Şereflican M, Geyik A, Göksügür N, Parlak AH. Dermatological diseases in patients with obstructive sleep apnea syndrome. Abant Med J. 2016;5(1):57-63.
  • Egeberg A, Khalid U, Gislason GH, Mallbris L, Skov L, Hansen PR. Psoriazis and sleep apnea: a Danish nationwide cohort study. J Clin Sleep Med. 2016;12(5):663-71.
  • Yang YW, Kang JH, Lin HC. Increased risk of psoriasis following obstructive sleep apnea: a longitudinal population-based study. Sleep Med. 2012;13(3):285-9.

Psoriazis Hastalarında Obstrüktif Uyku Apne Sendromu Semptom Sıklığı

Year 2019, Volume: 21 Issue: 2, 127 - 131, 30.08.2019
https://doi.org/10.18678/dtfd.560477

Abstract

Amaç: Psoriazis toplumda sık görülen, genel nüfusun %2-3’ünü etkileyen, birçok komorbiditenin eşlik ettiği kronik sistemik enflamatuvar bir hastalıktır. Psoriazis’e eşlik eden nadir görülen komorbiditeler arasında obstrüktif uyku apne sendromu (OUAS) yer almaktadır. OUAS uyku sırasında tekrarlayan tam (apne) veya parsiyel (hipopne) üst solunum yolu obstrüksiyonu epizodları ve sıklıkla kan oksijen satürasyonunda azalma ile karakterize bir hastalıktır. Bu çalışmanın amacı psoriazis hastalarında OUAS semptomları sorgulanarak, OUAS risk faktörlerini değerlendirmektir.

Gereç ve Yöntemler: Düzce Üniversitesi Tıp Fakültesi Deri ve Zührevi Hastalıkları polikliniğinden takipli ve Psoriazis tanılı 16 yaşından büyük 82 hasta çalışmaya alındı. Hastalar OUAS semptomları açısından sorgulandı. Aşırı gündüz uykululuğu değerlendirmek için ise Epworth uykululuk skalası kullanıldı.

Bulgular: Hastaların %51,2 (n=42)’sı erkek, %48,8 (n=40)’i kadındı. Hastaların yaş ortalaması 47,09±14,10 yıl idi. Hastaların ortalama psoriazis tanı süreleri 16,97±10,55 yıl, ortalama Psoriatik Alan Şiddet İndeksi (PAŞİ) 11,25±6,32 idi. PAŞİ sınıflamasına göre hastaların %54,9 (n=45)’ü şiddetliydi. Bu hastalarda horlama için %56,1, gündüz aşırı uyku hali için %25,6, tanıklı apne için %15,9’luk prevalans saptandı. En az bir semptomu olan olgu sayısı 47 (%57,3) idi. Minör semptomlar sorgulandığında en sık gözlenen %25,6 (n=21) ile uyuyamama ve %22,0 (n=18) ile yetersiz bölünmüş uyku şikayetiydi.

Sonuç: Psoriazis hastalarında OUAS semptom sıklığı yüksek olarak bulunmuştur. OUAS semptomları olan psoriazis hastaları muhakkak polisomnografik değerlendirme için ilgili uzmanlara yönlendirilmelidir.

References

  • Grozdev I, Korman N, Tsankov N. Psoriazis as a systemic disease. Clin Dermatol. 2014;32(3):343-50.
  • Kalkan G. Comorbidities in psoriasis: The recognition of psoriasis as a systemic disease and current management. Turkderm-Turk Arch Dermatol Venereolgy. 2017;51(3):71-7.
  • American Academy of Sleep Medicine. International Classification of sleep disorders: diagnostic and coding manual (ICSD-2). 2nd ed. Westchester, IL: American Academy of Sleep Medicine; 2005.
  • Rowley JA. Excessive daytime sleppiness: medicolegal aspects. In: Atwood CW, Phillips BA, editors. ACCP sleep medicine board review course syllabus 2007. Northbrook, IL: American College of Chest Physicians; 2007. p.177-83.
  • Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-5.
  • Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, et al. Psoriazis and comorbid diseases: epidemiology. J Am Acad Dermatol. 2017;76(3):377-90.
  • Gürer MA. Introduction to psoriasis. Turkderm-Turk Arch Dermatol Venereolgy. 2016;50(Suppl 1):2-3.
  • Machado-Pinto J, Diniz Mdos S, Bavoso NC. Psoriazis: new comorbidities. An Bras Dermatol. 2016; 91(1):8-14.
  • Oliveira Mde F, Rocha Bde O, Duarte GV. Psoriazis: classical and emerging comorbidities. An Bras Dermatol. 2015;90(1):9-20.
  • Wang F, Xiong X, Xu H, Huang H, Shi Y, Li X, et al. The association between obstructive sleep apnea syndrome and metabolic syndrome: a confirmatory factor analysis. Sleep Breath. 2019;23(3):1011-9.
  • Ljunggren M, Lindberg E, Franklin KA, Öhagen P, Larsson M, Theorell-Haglöw J, et al. Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women. Sleep. 2018;41(7):1-8.
  • Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-5.
  • Seneviratne U, Puvanendran K. Excessive day time sleepiness in obstructive sleep apnea: prevalence, severity, and predictors. Sleep Med. 2004;5(4):339-43.
  • Young T, Hutton R, Finn L, Badr S, Palta M. The gender bias in sleep apnea diagnosis. Are women missed because they have different symptoms? Arch Intern Med. 1996;156(21):2445-51.
  • Dursunoğlu N, Dursunoğlu D. Obstructive sleep apnea syndrome and cardiovascular complications. Updates on Pulmonary Diseases. 2014;2(2):159-69.
  • Lavie L. Obstructive sleep apnoea syndrome-an oxidative stres disorder. Sleep Med Rev. 2003;7(1):35-51.
  • Prodanovich S, Kirsner RS, Kravetz JD, Ma F, Martinez L, Federman DG. Association of psoriasis with coronary artery, cerebrovascular, and peripheral vascular diseases and mortality. Arch Dermatol. 2009;145(6):700-3.
  • Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296(14):1735-41.
  • Karaca S, Fidan F, Erkan F, Nural S, Pinarcı T, Gunay E, et al. Might psoriazis be a risk factor for obstructive sleep apnea syndrome? Sleep Breath. 2013;17(1):275-80.
  • Şereflican B, Kar Kurt Ö, Şereflican M, Geyik A, Göksügür N, Parlak AH. Dermatological diseases in patients with obstructive sleep apnea syndrome. Abant Med J. 2016;5(1):57-63.
  • Egeberg A, Khalid U, Gislason GH, Mallbris L, Skov L, Hansen PR. Psoriazis and sleep apnea: a Danish nationwide cohort study. J Clin Sleep Med. 2016;12(5):663-71.
  • Yang YW, Kang JH, Lin HC. Increased risk of psoriasis following obstructive sleep apnea: a longitudinal population-based study. Sleep Med. 2012;13(3):285-9.
There are 22 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Ebru Karagün 0000-0002-5032-7429

Ege Güleç Balbay 0000-0002-1557-7019

Publication Date August 30, 2019
Submission Date May 4, 2019
Published in Issue Year 2019 Volume: 21 Issue: 2

Cite

APA Karagün, E., & Güleç Balbay, E. (2019). Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients. Duzce Medical Journal, 21(2), 127-131. https://doi.org/10.18678/dtfd.560477
AMA Karagün E, Güleç Balbay E. Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients. Duzce Med J. August 2019;21(2):127-131. doi:10.18678/dtfd.560477
Chicago Karagün, Ebru, and Ege Güleç Balbay. “Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients”. Duzce Medical Journal 21, no. 2 (August 2019): 127-31. https://doi.org/10.18678/dtfd.560477.
EndNote Karagün E, Güleç Balbay E (August 1, 2019) Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients. Duzce Medical Journal 21 2 127–131.
IEEE E. Karagün and E. Güleç Balbay, “Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients”, Duzce Med J, vol. 21, no. 2, pp. 127–131, 2019, doi: 10.18678/dtfd.560477.
ISNAD Karagün, Ebru - Güleç Balbay, Ege. “Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients”. Duzce Medical Journal 21/2 (August 2019), 127-131. https://doi.org/10.18678/dtfd.560477.
JAMA Karagün E, Güleç Balbay E. Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients. Duzce Med J. 2019;21:127–131.
MLA Karagün, Ebru and Ege Güleç Balbay. “Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients”. Duzce Medical Journal, vol. 21, no. 2, 2019, pp. 127-31, doi:10.18678/dtfd.560477.
Vancouver Karagün E, Güleç Balbay E. Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients. Duzce Med J. 2019;21(2):127-31.