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

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

doi:10.5664/jcsm.6908

Cited by 23 publications

(20 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The increase of IL-17 is related to atherosclerotic vascular disease, which is a risk factor for OSA 50 . Moreover, psoriasis causes pruritus and may lead to sleep disturbance, which contributes to systemic inflammation and consequently induces OSA [51][52][53] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bidirectional Association Between Psoriasis and Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Ger

Chi

2020

Sci Rep

View full text Add to dashboard Cite

The link between psoriasis and obstructive sleep apnea (OSA) has not been confirmed. We aimed to investigate the relationship between psoriasis and OSA. We conducted a systematic review and metaanalysis of case-control, cross-sectional, and cohort studies on the association between psoriasis and OSA. We searched MEDLINE and Embase for relevant studies on May 11, 2019. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of included studies. We performed random-effects model meta-analysis to calculate pooled odds ratio (ORs) with 95% confidence intervals (CIs) for case-control and cross-sectional studies as well as pooled incidence rate ratio (IRR) with 95% CIs for cohort studies in association between psoriasis and OSA. A total of 4 case-control or cross-sectional studies and 3 cohort studies with a total of 5,840,495 subjects were included. We identified a significantly increased odds for OSA in psoriasis patients (pooled OR 2.60; 95% CI 1.07-6.32), and significantly increased risk for psoriasis in OSA patients (pooled IRR 2.52; 95% CI 1.89-3.36). In conclusion, our study identified a bidirectional association between psoriasis and OSA. Sleep quality should be inquired in patients with psoriasis. Respirologist consultation or polysomnography may be indicated for those presenting with night snoring, recurrent awaking, and excessive daytime sleepiness. Psoriasis is a chronic inflammatory skin disease with characteristic feature of sharply circumscribed erythematous plaques with silvery scales on the trunk and limbs 1. The prevalence was estimated 0.5-11.4% in adults 2. Psoriasis is considered as a multisystemic disease involving proinflammatory cytokines such as tumor necrosis factor (TNF), interleukin (IL)-1, and IL-17 3,4. Various comorbidities have been linked to psoriasis including cardiovascular disease, metabolic syndrome, chronic kidney disease, uveitis, thyroid diseases, vitiligo, and inflammatory bowel disease 5-11. Obstructive sleep apnea (OSA), also called obstructive sleep apnea-hypopnea syndrome, is a chronic disorder of intermittent upper airway collapse during sleep resulting in recurrent hypoxia 12,13. OSA is characterized with night snoring, recurrent awaking, and excessive daytime sleepiness 14. The gold standard test for diagnosing OSA is polysomnography 15. The prevalence of OSA ranges from 3 to 17% 12. Risk factors of OSA include obesity, aging, male gender, anatomical predisposition, and alcohol consumption 12,13. OSA induces systemic inflammatory and increases the risk of hypertension, stroke, cardiovascular disease, and metabolic disorder, in particular of diabetes mellitus type 2 and metabolic syndrome regardless of the obesity 15-17. Psoriasis and OSA share a common pathogenesis of inflammatory and immune imbalance 18,19. The association between psoriasis and OSA has been examined in many studies but the results were limited and inconsistent 20-27. The objective of this study was to assess the evidence regarding the bidirectional association between psoriasis and OSA. Methods ...

show abstract

Section: Discussionmentioning

confidence: 99%

“…Autonomic activation is considered an important factor between OSA and psoriasis [53][54][55] . Some scholars assumed that psoriasis-related itching and pain could disrupt sleep and thus increase autonomic activation, which possibly induces OSA 18,54 .…”

Section: Discussionmentioning

confidence: 99%

Bidirectional Association Between Psoriasis and Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Ger

Chi

2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Risk factors for OSA include obesity, male gender, older age, and higher neck circumference ( 5 ). Furthermore, it has been shown, that the patients diagnosed with OSA, more often suffer from immunological diseases that are associated with systemic inflammation ( 6 – 9 ) as well as metabolic disorders ( 10 , 11 ). For over 30 years continuous positive air pressure is method of choice for OSA treatment, as through inhibition of airways collapse it reduces AHI and recurrent hypoxia ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Obstructive Sleep Apnea: From Intermittent Hypoxia to Cardiovascular Complications via Blood Platelets

et al. 2018

Self Cite

View full text Add to dashboard Cite

Obstructive sleep apnea is a chronic condition characterized by recurrent episodes of apneas or hypopneas during sleep leading to intermittent hypoxemia and arousals. The prevalence of the sleep disordered breathing is estimated that almost 50% of men and 24% of women suffer from moderate to severe form of the disorder. Snoring, collapse of upper airways and intermittent hypoxia are main causes of smoldering systemic inflammation in patients suffering from obstructive sleep apnea. The systematic inflammation is considered one of the key mechanisms leading to significant cardiovascular complications. Blood platelets, formerly not even recognized as cells, are currently gaining attention as crucial players in the immune continuum. Platelet surface is endowed with receptors characteristic for cells classically belonging to the immune system, which enables them to recognize pathogens, immune complexes, and interact in a homo- and heterotypic aggregates. Platelets participate in the process of transcellular production of bioactive lipids by delivering both specific enzymes and substrate molecules. Despite their lack of nucleus, platelets synthetize proteins in a stimuli-dependent manner. Atherosclerosis and consequent cardiovascular complications result from disruption in homeostasis of both of the platelet roles: blood coagulation and inflammatory processes modulation. Platelet parameters, routinely evaluated as a part of complete blood count test, were proposed as markers of cardiovascular comorbidity in patients with obstructive sleep apnea. Platelets were found to be excessively activated in this group of patients, especially in obese subjects. Persistent activation results in enhanced spontaneous aggregability and change in cytokine production. Platelet-lymphocyte ratio was suggested as an independent marker for cardiovascular disease in obstructive sleep apnea syndrome and continuous positive air pressure therapy was found to have an impact on platelet parameters and phenotype. In this literature review we summarize the current knowledge on the subject of platelets involvement in obstructive sleep apnea syndrome and consider the possible pathways in which they contribute to cardiovascular comorbidity.

show abstract

“…The problem of disordered sleep in immune diseases has been recently widely studied [14,16,27,28]. To date, only a few studies have been published assessing sleep quality among IBD patients using mainly PSQI [14,29].…”

Section: Discussionmentioning

confidence: 99%

Determinants of Sleep Quality in Inflammatory Bowel Diseases

Sochal

Małecka‐Panas

Gabryelska

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

The causes of disordered sleep, frequently reported by patients with inflammatory bowel diseases (IBD), are poorly understood. The study aimed to evaluate sleep quality in IBD patients and to identify factors affecting their sleep. IBD patients (n = 133) and healthy controls (HC; n = 57) were included in the study and completed sleep questionnaires (Pittsburgh Sleep Quality Index (PSQI), Athens insomnia scale (AIS), and Epworth sleepiness scale (ESS)), Beck Depression Inventory (BDI), and pain scales (Visual Analogue Scale and Laitinen Pain Scale). IBD patients attained higher scores in all sleep questionnaires compared to HC: PSQI, AIS, and ESS (all p < 0.001). They also had prolonged sleep latency (p < 0.001) with reduced sleep efficiency (p < 0.001). Patients in exacerbation of IBD had higher scores in PSQI (p = 0.008), ESS (p = 0.009), but not in AIS, compared to those in remission. Participants with comorbid chronic diseases had higher scores in PSQI and AIS, but not in ESS, compared to others. Multiple regression revealed that the sleep questionnaire results were significantly affected by mood level (BDI), but not by the aforementioned pain scales. Sleep impairment in IBD patients is a common problem that deserves attention in everyday clinical practice and mood level seems to be the main factor affecting the quality of sleep in IBD patients.

show abstract

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

Abstract: Gabryelska 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.

Cited by 23 publications

References 6 publications

Bidirectional Association Between Psoriasis and Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Bidirectional Association Between Psoriasis and Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Obstructive Sleep Apnea: From Intermittent Hypoxia to Cardiovascular Complications via Blood Platelets

Determinants of Sleep Quality in Inflammatory Bowel Diseases

Contact Info

Product

Resources

About