Background Several pathological mechanisiums may underlies an association between sleep apnea and autoimmune diseases. There are few evidances of increasing risk of OSA in patients with rheumatoid arthritis, ankylosing spondylitis. The risk of OSA in RA or Sjogren syndrome (SS)was thought to be attributed to upper airway dryness with a resulting in a colappsibility or temporomandibular joint involvement (1,2). The association between asystemic autoimmune disease nd obstructive sleep apnea were not clear in Asian. We hypothesized that autoimmune diseases would predispose patients to the occurance of OSA.
Objectives To explore the association between the obstructive sleep apnea (OSA) and autoimmune diseases
Methods 52994 adult patients with systemic autoimmune diseases diagnoses recorded in the Taiwan National Health Insurance Research Database between 2002 and 2011, after excluding those with antecedent obstructive sleep apnea. A comparison cohort of 211976 participants was formed by age-, gender-matched controls. Multivariable Cox regression was performed on the two cohorts to compute the risk of OSA during follow-up period.
Results In patients with systemic autoimmune diseases, the overall risk for incident OSA was significantly higher than in controls (adjusted hazard ratio [HR] =1.58, 95% confidence interval [CI] =1.38–1.82). Risk of OSA in individual autoimmune diseases, including rheumatoid arthritis (RA), Sjögren's syndrome (SS) and Behçet disease, was also significantly higher than in controls (HR [95% CI] for RA, primary SS, secondary SS and Behçet disease were 1.36 [1.12–1.63], 2.28 [1.68–3.10], 2.88 [2.14–3.87] and 2.39 [1.43–4.01], respectively). Increased risk for systemic lupus erythematosus did not reach statistical significance (HR: 0.79 [0.49–1.28]).
Conclusions Patients with systemic autoimmune diseases including of RA, primary or secondary SS and Behçet disease were associated with a higher risk for developing OSA.
Usmani ZA, Hlavac M, Rischmueller M et al. Sleep disordered breathing in patients with primary Sjögren's syndrome: a group controlled study Sleep Med. 2012;13(8):1066–70
Reading SR, Crowson CS, Rodeheffer RJ et al. Do rheumatoid arthritis patients have a higher risk for sleep apnea? J Rheumatol. 2009;36(9):1869–72
Disclosure of Interest None declared