Skip to main content
Erschienen in: Sleep and Breathing 4/2017

08.05.2017 | Sleep Breathing Physiology and Disorders • Original Article

Psoriasis is associated with risk of obstructive sleep apnea independently from metabolic parameters and other comorbidities: a large hospital-based case-control study

verfasst von: Evangelia Papadavid, Maria Dalamaga, Katerina Vlami, Dimitra Koumaki, Sotirios Gyftopoulos, Gerasimos Socrates Christodoulatos, Spyridon Papiris, Dimitrios Rigopoulos

Erschienen in: Sleep and Breathing | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Obstructive sleep apnea (OSA) represents a breathing disorder during sleep with significant health consequences. Few studies have examined the prevalence of OSA in psoriatic patients and whether OSA may be associated with psoriasis risk. We aimed to explore: (1) the inverse relationship, that is whether psoriasis might represent an independent predictor of OSA and its severity considering important predisposing factors and (2) the psoriatic phenotype related to severe OSA.

Methods

In a large hospital-based case-control study, we examined a total of 253 patients with OSA and a control group of 104 subjects without OSA, who underwent full nocturnal polysomnography and dermatologic examination.

Results

The prevalence of psoriasis was significantly greater in OSA patients than in controls (p = 0.03). Psoriasis was associated with OSA risk (p = 0.04) but not severity of OSA, sleepiness severity or sleep efficiency, independently from age, gender, anthropometric features, and significant comorbidities. The phenotype of a psoriatic patient suffering from severe OSA is not different from that of a patient with severe OSA and is not associated with psoriasis severity indexes. OSA psoriatic patients were not compliant with CPAP treatment in comparison with OSA patients without psoriasis.

Conclusion

Psoriasis may represent an independent risk factor for OSA above and beyond significant comorbidities, anthropometric and metabolic parameters. Physicians should be aware of the bi-directional association of psoriasis and OSA. Managing psoriasis may be a potential target for preventing OSA as well as the potential cardiovascular mortality related to OSA and psoriasis.
Literatur
5.
Zurück zum Zitat Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V, Preisig M, Malhotra A, Waeber G, Vollenweider P, Tafti M, Haba-Rubio J (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3:310–318. doi:10.1016/s2213-2600(15)00043-0 CrossRefPubMedPubMedCentral Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V, Preisig M, Malhotra A, Waeber G, Vollenweider P, Tafti M, Haba-Rubio J (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3:310–318. doi:10.​1016/​s2213-2600(15)00043-0 CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Dalamaga M, Papadavid E (2013) Adipocytokines and psoriasis: insights into mechanisms linking obesity and inflammation to psoriasis. World J Dermatol 2:27–31CrossRef Dalamaga M, Papadavid E (2013) Adipocytokines and psoriasis: insights into mechanisms linking obesity and inflammation to psoriasis. World J Dermatol 2:27–31CrossRef
10.
Zurück zum Zitat Dalamaga M, Papadavid E (2013) Metabolic comorbidities and psoriasis: the chicken or the egg? World J Dermatol 2:32–35CrossRef Dalamaga M, Papadavid E (2013) Metabolic comorbidities and psoriasis: the chicken or the egg? World J Dermatol 2:32–35CrossRef
12.
Zurück zum Zitat Hirotsu C, Nogueira H, Albuquerque RG, Tomimori J, Tufik S, Andersen ML (2015) The bidirectional interactions between psoriasis and obstructive sleep apnea. Int J Dermatol 54:1352–1358. doi:10.1111/ijd.13026 CrossRefPubMed Hirotsu C, Nogueira H, Albuquerque RG, Tomimori J, Tufik S, Andersen ML (2015) The bidirectional interactions between psoriasis and obstructive sleep apnea. Int J Dermatol 54:1352–1358. doi:10.​1111/​ijd.​13026 CrossRefPubMed
13.
Zurück zum Zitat Papadavid E, Vlami K, Dalamaga M, Giatrakou S, Theodoropoulos K, Gyftopoulos S, Stavrianeas N, Papiris S, Rigopoulos D (2013) Sleep apnea as a comorbidity in obese psoriasis patients: a cross-sectional study. Do psoriasis characteristics and metabolic parameters play a role? J Eur Acad Dermatol Venereol 27:820–826. doi:10.1111/j.1468-3083.2012.04580.x CrossRefPubMed Papadavid E, Vlami K, Dalamaga M, Giatrakou S, Theodoropoulos K, Gyftopoulos S, Stavrianeas N, Papiris S, Rigopoulos D (2013) Sleep apnea as a comorbidity in obese psoriasis patients: a cross-sectional study. Do psoriasis characteristics and metabolic parameters play a role? J Eur Acad Dermatol Venereol 27:820–826. doi:10.​1111/​j.​1468-3083.​2012.​04580.​x CrossRefPubMed
19.
Zurück zum Zitat Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRefPubMed Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRefPubMed
20.
Zurück zum Zitat Iber C, Ancoli-Israel S, Stuart Quan M (2007) The American Academy of Sleep Medicine Manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. American Academy of Sleep Medicine, Westchester, Illinois Iber C, Ancoli-Israel S, Stuart Quan M (2007) The American Academy of Sleep Medicine Manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. American Academy of Sleep Medicine, Westchester, Illinois
21.
Zurück zum Zitat Bassukas ID, Mavridou KA, Evangelou T, Gaitanis G (2011) The prevalence of psoriasis among elderly individuals: more questions than answers. Ageing Res 3(e1):1–2. doi:10.4081/ar.2011.e1 CrossRef Bassukas ID, Mavridou KA, Evangelou T, Gaitanis G (2011) The prevalence of psoriasis among elderly individuals: more questions than answers. Ageing Res 3(e1):1–2. doi:10.​4081/​ar.​2011.​e1 CrossRef
24.
25.
Zurück zum Zitat van der Voort EA, Koehler EM, Dowlatshahi EA, Hofman A, Stricker BH, Janssen HL, Schouten JN, Nijsten T (2014) Psoriasis is independently associated with nonalcoholic fatty liver disease in patients 55 years old or older: results from a population-based study. J Am Acad Dermatol 70:517–524. doi:10.1016/j.jaad.2013.10.044 CrossRefPubMed van der Voort EA, Koehler EM, Dowlatshahi EA, Hofman A, Stricker BH, Janssen HL, Schouten JN, Nijsten T (2014) Psoriasis is independently associated with nonalcoholic fatty liver disease in patients 55 years old or older: results from a population-based study. J Am Acad Dermatol 70:517–524. doi:10.​1016/​j.​jaad.​2013.​10.​044 CrossRefPubMed
27.
Zurück zum Zitat Hjuler KF, Bottcher M, Vestergaard C, Botker HE, Iversen L, Kragballe K (2016) Association between changes in coronary artery disease progression and treatment with biologic agents for severe psoriasis. JAMA Dermatol 152:1114–1121. doi:10.1001/jamadermatol.2016.1984 CrossRefPubMed Hjuler KF, Bottcher M, Vestergaard C, Botker HE, Iversen L, Kragballe K (2016) Association between changes in coronary artery disease progression and treatment with biologic agents for severe psoriasis. JAMA Dermatol 152:1114–1121. doi:10.​1001/​jamadermatol.​2016.​1984 CrossRefPubMed
28.
Zurück zum Zitat Maari C, Bolduc C, Nigen S, Marchessault P, Bissonnette R (2014) Effect of adalimumab on sleep parameters in patients with psoriasis and obstructive sleep apnea: a randomized controlled trial. J Dermatolog Treat 25:57–60. doi:10.3109/09546634.2012.713458 CrossRefPubMed Maari C, Bolduc C, Nigen S, Marchessault P, Bissonnette R (2014) Effect of adalimumab on sleep parameters in patients with psoriasis and obstructive sleep apnea: a randomized controlled trial. J Dermatolog Treat 25:57–60. doi:10.​3109/​09546634.​2012.​713458 CrossRefPubMed
29.
Zurück zum Zitat Buslau M, Benotmane K (1999) Cardiovascular complications of psoriasis: does obstructive sleep apnoea play a role? Acta Derm Venereol 79:234CrossRefPubMed Buslau M, Benotmane K (1999) Cardiovascular complications of psoriasis: does obstructive sleep apnoea play a role? Acta Derm Venereol 79:234CrossRefPubMed
30.
Zurück zum Zitat Yang XQ, You L, Zhang-Rui J (2007) Study of sleep quality in patients with psoriasis. Institute of Aviation Medicine. J Invest Dermatol 127:1809 Yang XQ, You L, Zhang-Rui J (2007) Study of sleep quality in patients with psoriasis. Institute of Aviation Medicine. J Invest Dermatol 127:1809
31.
Zurück zum Zitat Preis SR, Massaro JM, Hoffmann U, D'Agostino RB Sr, Levy D, Robins SJ, Meigs JB, Vasan RS, O'Donnell CJ, Fox CS (2010) Neck circumference as a novel measure of cardiometabolic risk: the Framingham heart study. J Clin Endocrinol Metab 95:3701–3710. doi:10.1210/jc.2009-1779 CrossRefPubMedPubMedCentral Preis SR, Massaro JM, Hoffmann U, D'Agostino RB Sr, Levy D, Robins SJ, Meigs JB, Vasan RS, O'Donnell CJ, Fox CS (2010) Neck circumference as a novel measure of cardiometabolic risk: the Framingham heart study. J Clin Endocrinol Metab 95:3701–3710. doi:10.​1210/​jc.​2009-1779 CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Vgontzas AN (2008) Does obesity play a major role in the pathogenesis of sleep apnoea and its associated manifestations via inflammation, visceral adiposity, and insulin resistance? Arch Physiol Biochem 114:211–223. doi:10.1080/13813450802364627 CrossRefPubMed Vgontzas AN (2008) Does obesity play a major role in the pathogenesis of sleep apnoea and its associated manifestations via inflammation, visceral adiposity, and insulin resistance? Arch Physiol Biochem 114:211–223. doi:10.​1080/​1381345080236462​7 CrossRefPubMed
36.
Zurück zum Zitat Bonsignore MR, Eckel J (2009) ERS meeting report. Metabolic aspects of obstructive sleep apnoea syndrome. Eur Respir Rev 18:113–124 Bonsignore MR, Eckel J (2009) ERS meeting report. Metabolic aspects of obstructive sleep apnoea syndrome. Eur Respir Rev 18:113–124
40.
Zurück zum Zitat Steiropoulos P, Papanas N, Nena E, Antoniadou M, Serasli E, Papoti S, Hatzizisi O, Kyriazis G, Tzouvelekis A, Maltezos E, Tsara V, Bouros D (2010) Inflammatory markers in middle-aged obese subjects: does obstructive sleep apnea syndrome play a role? Mediat Inflamm 2010:675320. doi:10.1155/2010/675320 CrossRef Steiropoulos P, Papanas N, Nena E, Antoniadou M, Serasli E, Papoti S, Hatzizisi O, Kyriazis G, Tzouvelekis A, Maltezos E, Tsara V, Bouros D (2010) Inflammatory markers in middle-aged obese subjects: does obstructive sleep apnea syndrome play a role? Mediat Inflamm 2010:675320. doi:10.​1155/​2010/​675320 CrossRef
43.
Zurück zum Zitat Peppard PE, Young T, Palta M, Dempsey J, Skatrud J (2000) Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 284:3015–3021CrossRefPubMed Peppard PE, Young T, Palta M, Dempsey J, Skatrud J (2000) Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 284:3015–3021CrossRefPubMed
46.
Zurück zum Zitat Harsch IA, Schahin SP, Radespiel-Troger M, Weintz O, Jahreiss H, Fuchs FS, Wiest GH, Hahn EG, Lohmann T, Konturek PC, Ficker JH (2004) Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 169:156–162. doi:10.1164/rccm.200302-206OC CrossRefPubMed Harsch IA, Schahin SP, Radespiel-Troger M, Weintz O, Jahreiss H, Fuchs FS, Wiest GH, Hahn EG, Lohmann T, Konturek PC, Ficker JH (2004) Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 169:156–162. doi:10.​1164/​rccm.​200302-206OC CrossRefPubMed
47.
Zurück zum Zitat Weaver TE, Sawyer AM (2010) Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions. Indian J Med Res 131:245–258PubMedPubMedCentral Weaver TE, Sawyer AM (2010) Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions. Indian J Med Res 131:245–258PubMedPubMedCentral
48.
Zurück zum Zitat Vgontzas AN, Zoumakis E, Lin HM, Bixler EO, Trakada G, Chrousos GP (2004) Marked decrease in sleepiness in patients with sleep apnea by etanercept, a tumor necrosis factor-alpha antagonist. J Clin Endocrinol Metab 89:4409–4413. doi:10.1210/jc.2003-031929 CrossRefPubMed Vgontzas AN, Zoumakis E, Lin HM, Bixler EO, Trakada G, Chrousos GP (2004) Marked decrease in sleepiness in patients with sleep apnea by etanercept, a tumor necrosis factor-alpha antagonist. J Clin Endocrinol Metab 89:4409–4413. doi:10.​1210/​jc.​2003-031929 CrossRefPubMed
Metadaten
Titel
Psoriasis is associated with risk of obstructive sleep apnea independently from metabolic parameters and other comorbidities: a large hospital-based case-control study
verfasst von
Evangelia Papadavid
Maria Dalamaga
Katerina Vlami
Dimitra Koumaki
Sotirios Gyftopoulos
Gerasimos Socrates Christodoulatos
Spyridon Papiris
Dimitrios Rigopoulos
Publikationsdatum
08.05.2017
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 4/2017
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-017-1507-4

Weitere Artikel der Ausgabe 4/2017

Sleep and Breathing 4/2017 Zur Ausgabe

Sleep Breathing Physiology and Disorders • Original Article

The effect of sleep duration on exhaled nitric oxide levels in U.S. adults

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.