Patients with psoriasis should be opportunistically screened for obstructive sleep apnea, an independent risk factor for cardiovascular disease, said the authors of a recent study.
Cardiovascular disease is among the leading causes of death for patients with psoriasis, a fact thought to be linked with the inflammation that psoriasis causes. Additionally, obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular disease and has been reported to be associated with hypertension, heart failure, atrial fibrillation, and a spectrum of other cardiac disturbances and sudden cardiac death.
Previous research has noted that many patients with psoriasis have sleep disorders that include OSA, making this sleep disorder one of particular concern for the patient with psoriasis. In a study presented at the British Association of Dermatologists’ 99th Annual Meeting in Liverpool, United Kingdom, in July 2019, researchers from St. Vincent’s University Hospital in Dublin, Ireland, reported on a study conducted in patients with both psoriasis and hidradenitis suppurativa (HS) in which they found that there was a high prevalence of OSA among these patients.
The researchers recruited 38 patients with HS and 39 patients with psoriasis to complete 3 validated screening questionnaires for OSA, and patients also had their neck circumference, waist circumference, body mass index (BMI), blood pressure, lipid profile, insulin level, and C-reactive protein level recorded. Overall, the majority of patients (82% in the psoriasis group and 76% in the HS group) had obesity or overweight as measured by BMI. The mean Psoriasis Area and Severity Index score among the patients with psoriasis was 4.8.
The researchers found that 50% of the HS patients and 34% of the psoriasis patients had a high probability of having sleep apnea based on their responses to the questionnaires. Patients with more severe HS had a higher risk of OSA, and patients who had obesity had a significantly higher risk of OSA (odds ratio, 14.0; P = .03).
While the patients with HS had a higher risk for OSA than patients with psoriasis, both groups of patients had a high prevalence of OSA as assessed using the validated questionnaires.
“Both patients with HS and patients with psoriasis should be opportunistically screened for OSA in order to identify and treat modifiable cardiovascular disease risk factors,” concluded the study's authors.
Kelly A, Ryan C, Meurling J, Hughes R, Garvey J, Kirby B. Obstructive sleep apnoea in patients with hidradenitis suppurativa and psoriasis. Presented at: British Association of Dermatologists’ 99th Annual Meeting; July 2-4, 2019; Liverpool, United Kingdom. Abstract P043.