Might psoriasis be a risk factor for obstructive sleep apnea syndrome?

It is believed that psoriasis is a chronic systemic inflammatory disease. Obstructive sleep apnea syndrome (OSAS) is a disease influencing all systems and characterized by intermittent partial or complete obstruction of the upper respiratory tract during sleep. In our study, we aimed to investigate the frequency of OSAS in patients previously diagnosed with psoriasis in order to investigate a potential association between chronic inflammation psoriasis and OSAS.

Thirty-three patients diagnosed with psoriasis by biopsy were enrolled into the study. Demographics of patients, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), and Epworth Sleepiness Scale were examined. All patients underwent polysomnography.

OSAS was determined in 18 of 33 patients with psoriasis (54.5 %). Eleven of the 18 patients had mild, 2 had moderate, and 5 had severe OSAS. Mean age was significantly higher in the OSAS group in comparison with non-OSAS group (54.4 ± 15.5 vs 39.4 ± 11.8, respectively, p < 0.05). Mean PASI was higher in the OSAS group in comparison with that of non-OSAS group, and the difference was not significant, although mean DLQI was lower (p > 0.05). It is believed that this was caused by the small patient population.

We detected that the frequency of OSAS in patients with psoriasis was much higher than that in the normal population. Though OSAS is not easy to diagnose without detailed testing, it should be investigated in psoriatic patients with long disease duration and high PASI score, and patients refractory to conventional systemic treatment. Physicians treating patients with psoriatic disease should incorporate this life-altering comorbidity into their assessment of disease and selection of treatment.