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Erschienen in: Sleep and Breathing 3/2020

01.09.2020 | Epidemiology • Original Article

Risk of obstructive sleep apnea in patients with Sjögren syndrome and Behçet’s disease: a nationwide, population-based cohort study

verfasst von: Tsai-Chu Yeh, Wei-Sheng Chen, Yu-Sheng Chang, Yi-Chun Lin, Yi-Hsiang Huang, Chang-Youh Tsai, Jin-Hua Chen, Chi-Ching Chang

Erschienen in: Sleep and Breathing | Ausgabe 3/2020

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Abstract

Purpose

Patients with obstructive sleep apnea (OSA) have a higher risk of Behçet’s disease (BD) and Sjögren syndrome (SS). However, the bidirectional relationship between these autoimmune diseases and OSA is unclear. We investigated the relationship between autoimmune diseases (SS and BD) and OSA.

Methods

SS and BD patients were identified through the Taiwan National Health Insurance Research Database from 2002 to 2012. Patients with SS or BD were matched according to age and sex with a control group in a ratio of 1:4. The study included 12,926 patients with SS and 51,704 non-SS controls. Similarly, 1221 patients with BD were matched with 4884 non-BD controls. We used a Cox regression model, stratified by age, gender, and comorbidities, to assess the risk of OSA.

Results

OSA was diagnosed in 0.61% of the SS cohort and 1.23% of the BD cohort. The higher overall risk for OSA was observed significantly in patients with SS than in controls (adjusted hazard ratio [HR] = 2.48, 95% confidence interval [CI] = 1.89–3.24). The higher risk was also observed significantly in BD patients than in controls (HR = 1.99, 95% CI = 1.06–3.72). Furthermore, men with SS or BD exhibited HR of 2.62 (95% CI 1.89 to 3.62) and 6.40 (95% CI 2.96 to 13.84) for developing OSA, respectively.

Conclusion

Risk of OSA was significantly elevated in SS or BD patients compared with controls. Further study is warranted to elucidate underlying mechanisms.
Literatur
1.
Zurück zum Zitat Pretto JJ, Gyulay SG, Hensley MJ (2010) Trends in anthropometry and severity of sleep-disordered breathing over two decades of diagnostic sleep studies in an Australian adult sleep laboratory. Med J Australia 193:213–216CrossRef Pretto JJ, Gyulay SG, Hensley MJ (2010) Trends in anthropometry and severity of sleep-disordered breathing over two decades of diagnostic sleep studies in an Australian adult sleep laboratory. Med J Australia 193:213–216CrossRef
2.
Zurück zum Zitat Punjabi NM, Caffo BS, Goodwin JL, Gottlieb DJ, Newman AB, O’Connor GT (2009) Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med 6:e1000132CrossRef Punjabi NM, Caffo BS, Goodwin JL, Gottlieb DJ, Newman AB, O’Connor GT (2009) Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med 6:e1000132CrossRef
3.
Zurück zum Zitat Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA 283:1829–1836CrossRef Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA 283:1829–1836CrossRef
4.
Zurück zum Zitat Peker Y, Carlson J, Hedner J (2006) Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up. Eur Respir J 28:596–602CrossRef Peker Y, Carlson J, Hedner J (2006) Increased incidence of coronary artery disease in sleep apnoea: a long-term follow-up. Eur Respir J 28:596–602CrossRef
5.
Zurück zum Zitat Punjabi NM, Vsevolod YV (2005) Disorders of glucose metabolism in sleep apnea. J Appl Physiol 99:1998–2007CrossRef Punjabi NM, Vsevolod YV (2005) Disorders of glucose metabolism in sleep apnea. J Appl Physiol 99:1998–2007CrossRef
6.
Zurück zum Zitat Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3:310–318CrossRef Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3:310–318CrossRef
7.
Zurück zum Zitat Rose NR (2016) Prediction and prevention of autoimmune disease in the 21st century: a review and preview. Am J Epidemiol 183:403–406CrossRef Rose NR (2016) Prediction and prevention of autoimmune disease in the 21st century: a review and preview. Am J Epidemiol 183:403–406CrossRef
8.
Zurück zum Zitat Haugen AJ, Peen E, Hulten B, Johannessen AC, Brun JG, Halse AK (2008) Estimation of the prevalence of primary Sjögren’s syndrome in two age-different community-based populations using two sets of classification criteria: the Hordaland Health Study. Scand J of Rheumatol 37:30–34CrossRef Haugen AJ, Peen E, Hulten B, Johannessen AC, Brun JG, Halse AK (2008) Estimation of the prevalence of primary Sjögren’s syndrome in two age-different community-based populations using two sets of classification criteria: the Hordaland Health Study. Scand J of Rheumatol 37:30–34CrossRef
9.
Zurück zum Zitat Mavragani CP, Moutsopoulos HM (2010) The geoepidemiology of Sjögren’s syndrome. Autoimmun Rev 9(5):A305–A310CrossRef Mavragani CP, Moutsopoulos HM (2010) The geoepidemiology of Sjögren’s syndrome. Autoimmun Rev 9(5):A305–A310CrossRef
10.
Zurück zum Zitat O’Duffy JD (1994) Behçet’s disease. Curr Opin Rheumatol 6:39–34CrossRef O’Duffy JD (1994) Behçet’s disease. Curr Opin Rheumatol 6:39–34CrossRef
11.
Zurück zum Zitat Abad VC, Sarinas PS, Guilleminault C (2008) Sleep and rheumatologic disorders. Sleep Med Rev 12:211–228CrossRef Abad VC, Sarinas PS, Guilleminault C (2008) Sleep and rheumatologic disorders. Sleep Med Rev 12:211–228CrossRef
12.
Zurück zum Zitat Minoguchi K, Yokoe T, Tazaki T, Minoguchi H, Tanaka A, Oda N (2005) Increased carotid intima-media thickness and serum inflammatory markers in obstructive sleep apnea. Am J Respir Crit Care Med 172:625–630CrossRef Minoguchi K, Yokoe T, Tazaki T, Minoguchi H, Tanaka A, Oda N (2005) Increased carotid intima-media thickness and serum inflammatory markers in obstructive sleep apnea. Am J Respir Crit Care Med 172:625–630CrossRef
13.
Zurück zum Zitat Baessler A, Nadeem R, Harvey M, Madbouly E, Younus A, Sajid H (2013) Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers--a meta-analysis. J Inflamm (Lond) 10:13CrossRef Baessler A, Nadeem R, Harvey M, Madbouly E, Younus A, Sajid H (2013) Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers--a meta-analysis. J Inflamm (Lond) 10:13CrossRef
14.
Zurück zum Zitat Kang JH, Lin HC (2012) Obstructive sleep apnea and the risk of autoimmune diseases: a longitudinal population-based study. Sleep Med 13:583–588CrossRef Kang JH, Lin HC (2012) Obstructive sleep apnea and the risk of autoimmune diseases: a longitudinal population-based study. Sleep Med 13:583–588CrossRef
15.
Zurück zum Zitat National Health Insurance. Taiwan public health report 2007. Taipei City: Department of Health, R.O.C.2008 (Taiwan),103. National Health Insurance. Taiwan public health report 2007. Taipei City: Department of Health, R.O.C.2008 (Taiwan),103.
16.
Zurück zum Zitat Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE (2002) Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61:554–558CrossRef Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE (2002) Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61:554–558CrossRef
17.
Zurück zum Zitat International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335:1078–1080 International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335:1078–1080
18.
Zurück zum Zitat McNicholas W (2009) Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease. Am J Respir Crit Care Med 180:692–700CrossRef McNicholas W (2009) Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease. Am J Respir Crit Care Med 180:692–700CrossRef
19.
Zurück zum Zitat Hatipoğlu U, Israel R (2004) Inflammation and obstructive sleep apnea syndrome pathogenesis: a working hypothesis. Respiration 70:665–671CrossRef Hatipoğlu U, Israel R (2004) Inflammation and obstructive sleep apnea syndrome pathogenesis: a working hypothesis. Respiration 70:665–671CrossRef
20.
Zurück zum Zitat Haensel A, Bardwell WA, Mills PJ, Loredo JS, Ancoli-Israel S, Morgan EE (2009) Relationship between inflammation and cognitive function in obstructive sleep apnea. Sleep Breath 13:35–41CrossRef Haensel A, Bardwell WA, Mills PJ, Loredo JS, Ancoli-Israel S, Morgan EE (2009) Relationship between inflammation and cognitive function in obstructive sleep apnea. Sleep Breath 13:35–41CrossRef
21.
Zurück zum Zitat Chen WS, Chang YS, Chang CC, Chang DM, Chen YH, Tsai CY, Chen JH (2016) Management and risk reduction of rheumatoid arthritis in individuals with obstructive sleep apnea: a nationwide population-based study in Taiwan. Sleep. 39:1883–1890CrossRef Chen WS, Chang YS, Chang CC, Chang DM, Chen YH, Tsai CY, Chen JH (2016) Management and risk reduction of rheumatoid arthritis in individuals with obstructive sleep apnea: a nationwide population-based study in Taiwan. Sleep. 39:1883–1890CrossRef
22.
Zurück zum Zitat Karadağ Ö, Nakas D, Kalyoncu U, Akdoğan A, Kiraz S, Ertenli I (2012) Effect of anti-TNF treatment on sleep problems in ankylosing spondylitis. Rheumatol Int 32:1909–1913CrossRef Karadağ Ö, Nakas D, Kalyoncu U, Akdoğan A, Kiraz S, Ertenli I (2012) Effect of anti-TNF treatment on sleep problems in ankylosing spondylitis. Rheumatol Int 32:1909–1913CrossRef
23.
Zurück zum Zitat Chandrasekhara PK, Jayachandran NV, Rajasekhar L, Thomas J, Narsimulu G (2009) The prevalence and associations of sleep disturbances in patients with systemic lupus erythematosus. Mod Rheumatol 19:407–415CrossRef Chandrasekhara PK, Jayachandran NV, Rajasekhar L, Thomas J, Narsimulu G (2009) The prevalence and associations of sleep disturbances in patients with systemic lupus erythematosus. Mod Rheumatol 19:407–415CrossRef
24.
Zurück zum Zitat Mirrakhimov AE (2013) Obstructive sleep apnea and autoimmune rheumatic disease: is there any link? Inflamm Allergy Drug Targets 12:362–367CrossRef Mirrakhimov AE (2013) Obstructive sleep apnea and autoimmune rheumatic disease: is there any link? Inflamm Allergy Drug Targets 12:362–367CrossRef
25.
Zurück zum Zitat Kamath J, Galina P, Sarah J (2015) Sleep disturbances in patients with medical conditions. Psych Clin North Am 38:825–841CrossRef Kamath J, Galina P, Sarah J (2015) Sleep disturbances in patients with medical conditions. Psych Clin North Am 38:825–841CrossRef
26.
Zurück zum Zitat Usmani ZA, Hlavac M, Rischmueller M, Heraganahally SS, Hilditch CJ, Lester S, Catcheside PG (2012) Sleep disordered breathing in patients with primary Sjögren’s syndrome: a group controlled study. Sleep Med 13:1066–1070CrossRef Usmani ZA, Hlavac M, Rischmueller M, Heraganahally SS, Hilditch CJ, Lester S, Catcheside PG (2012) Sleep disordered breathing in patients with primary Sjögren’s syndrome: a group controlled study. Sleep Med 13:1066–1070CrossRef
27.
Zurück zum Zitat Cai FZ, Lester S, Lu T, Boundy K, Proudman SM, Tonkin A, Rischmueller M (2008) Mild autonomic dysfunction in primary Sjögren’s syndrome: a controlled study. Arthritis Res Ther 10:R31CrossRef Cai FZ, Lester S, Lu T, Boundy K, Proudman SM, Tonkin A, Rischmueller M (2008) Mild autonomic dysfunction in primary Sjögren’s syndrome: a controlled study. Arthritis Res Ther 10:R31CrossRef
28.
Zurück zum Zitat Gudbjörnsson B, Broman JE, Hetta J, Hällgren R (1993) Sleep disturbances in patients with primary Sjögren’s syndrome. Br J Rheumatol 32:1072–1076CrossRef Gudbjörnsson B, Broman JE, Hetta J, Hällgren R (1993) Sleep disturbances in patients with primary Sjögren’s syndrome. Br J Rheumatol 32:1072–1076CrossRef
29.
Zurück zum Zitat Oksenberg A, Froom P, Melamed S (2006) Dry mouth upon awakening in obstructive sleep apnea. J Sleep Res 15:317–320CrossRef Oksenberg A, Froom P, Melamed S (2006) Dry mouth upon awakening in obstructive sleep apnea. J Sleep Res 15:317–320CrossRef
30.
Zurück zum Zitat Tascilar NF, Tekin NS, Ankarali H, Sezer T, Atik L, Emre U, Duysak S, Cinar F (2012) Sleep disorders in Behçet’s disease, and their relationship with fatigue and quality of life. J Sleep Res 21:281–288CrossRef Tascilar NF, Tekin NS, Ankarali H, Sezer T, Atik L, Emre U, Duysak S, Cinar F (2012) Sleep disorders in Behçet’s disease, and their relationship with fatigue and quality of life. J Sleep Res 21:281–288CrossRef
31.
Zurück zum Zitat Uygunoğlu U, Benbir G, Saip S, Kaynak H, Siva A (2014) A polysomnographic and clinical study of sleep disorders in patients with Behçet and neuro-Behçet syndrome. Eur Neurol 71:115–119CrossRef Uygunoğlu U, Benbir G, Saip S, Kaynak H, Siva A (2014) A polysomnographic and clinical study of sleep disorders in patients with Behçet and neuro-Behçet syndrome. Eur Neurol 71:115–119CrossRef
Metadaten
Titel
Risk of obstructive sleep apnea in patients with Sjögren syndrome and Behçet’s disease: a nationwide, population-based cohort study
verfasst von
Tsai-Chu Yeh
Wei-Sheng Chen
Yu-Sheng Chang
Yi-Chun Lin
Yi-Hsiang Huang
Chang-Youh Tsai
Jin-Hua Chen
Chi-Ching Chang
Publikationsdatum
01.09.2020
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 3/2020
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-019-01953-w

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