Obstructive Sleep Apnea in Psoriatic Arthritis: Clinical Characteristics and Comorbidities

Area of Science:

• Rheumatology
• Sleep Medicine
• Immunology

Background:

• Psoriatic arthritis (PsA) is a chronic inflammatory disease with poorly understood associations with obstructive sleep apnea (OSA).
• Limited data exists on OSA prevalence and its clinical impact in PsA patients.

Purpose of the Study:

• To determine the prevalence of OSA in a PsA cohort.
• To investigate the relationship between OSA and disease activity, functional impairment, and comorbidities in PsA.

Main Methods:

• Cross-sectional study of 247 PsA patients.
• OSA diagnosis via medical record review.
• Assessment of disease activity (cDAPSA, ASDAS-CRP), functional disability (HAQ-DI, BASFI), sleep quality (PSQI), psychological symptoms (HADS), and inflammatory markers (CRP, IL-6, TNF-α).
• Multivariable logistic regression for predictor identification.

Main Results:

• OSA prevalence was 8.9%.
• OSA+ patients exhibited higher age, tender joint counts, functional disability, fatigue, anxiety, depression, and poorer sleep quality.
• No significant differences in inflammatory markers (CRP, swollen joints) were observed between OSA+ and OSA- groups.
• Female sex and tender joint count were independent predictors of OSA.

Conclusions:

• OSA is present in approximately 9% of PsA patients and is linked to functional disability and psychological distress.
• The association of OSA with pain in PsA appears to be driven by non-inflammatory mechanisms.
• Systematic OSA screening is recommended for PsA patients with disproportionate pain or disability, especially those with psychological comorbidities.