Bidirectional Association Between Psoriasis and Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Overview

Journal Sci Rep

Specialty Science

Date 2020 Apr 5

PMID 32246124

Citations 8

Authors

Tzong-Yun Ger

Yun Fu

Ching-Chi Chi

Affiliations

Soon will be listed here.

Abstract

The link between psoriasis and obstructive sleep apnea (OSA) has not been confirmed. We aimed to investigate the relationship between psoriasis and OSA. We conducted a systematic review and meta-analysis of case-control, cross-sectional, and cohort studies on the association between psoriasis and OSA. We searched MEDLINE and Embase for relevant studies on May 11, 2019. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of included studies. We performed random-effects model meta-analysis to calculate pooled odds ratio (ORs) with 95% confidence intervals (CIs) for case-control and cross-sectional studies as well as pooled incidence rate ratio (IRR) with 95% CIs for cohort studies in association between psoriasis and OSA. A total of 4 case-control or cross-sectional studies and 3 cohort studies with a total of 5,840,495 subjects were included. We identified a significantly increased odds for OSA in psoriasis patients (pooled OR 2.60; 95% CI 1.07-6.32), and significantly increased risk for psoriasis in OSA patients (pooled IRR 2.52; 95% CI 1.89-3.36). In conclusion, our study identified a bidirectional association between psoriasis and OSA. Sleep quality should be inquired in patients with psoriasis. Respirologist consultation or polysomnography may be indicated for those presenting with night snoring, recurrent awaking, and excessive daytime sleepiness.

Citing Articles

Roles of BMI in mediating the causal effect of obstructive sleep apnea on psoriasis: a two-step mendelian randomization study.

Wang H, Yang B, Zeng X, Zhang S, Jiang Y, Wang L Arch Dermatol Res. 2024; 317(1):94.

PMID: 39656309 DOI: 10.1007/s00403-024-03619-4.

Psoriasis and Seasonality: Exploring the Genetic and Epigenetic Interactions.

Niedzwiedz M, Skibinska M, Ciazynska M, Noweta M, Czerwinska A, Krzyscin J Int J Mol Sci. 2024; 25(21).

PMID: 39519223 PMC: 11547062. DOI: 10.3390/ijms252111670.

Association of psoriasis with obstructive sleep apnea: a retrospective cohort study using the TriNetX dataset.

Patil M, Rohan T, Venkatesh K, Milosavljevic S, Salazar C, Sakunchotpanit G Arch Dermatol Res. 2024; 316(9):666.

PMID: 39382600 DOI: 10.1007/s00403-024-03412-3.

Do Sleep Disorders and Western Diet Influence Psoriasis? A Scoping Review.

Controne I, Scoditti E, Buja A, Pacifico A, Kridin K, Fabbro M Nutrients. 2022; 14(20).

PMID: 36297008 PMC: 9608488. DOI: 10.3390/nu14204324.

Psoriasis and medical ramifications: A comprehensive analysis based on observational meta-analyses.

Zhou Y, Zhong L, Shen L, Chen S, Zeng Q, Lai L Front Med (Lausanne). 2022; 9:998815.

PMID: 36106326 PMC: 9465012. DOI: 10.3389/fmed.2022.998815.

References

Hernan M . The hazards of hazard ratios. Epidemiology. 2009; 21(1):13-5. PMC: 3653612. DOI: 10.1097/EDE.0b013e3181c1ea43. View

Yosipovitch G, Goon A, Wee J, Chan Y, Goh C . The prevalence and clinical characteristics of pruritus among patients with extensive psoriasis. Br J Dermatol. 2000; 143(5):969-73. DOI: 10.1046/j.1365-2133.2000.03829.x. View

Yue H, Mills P, Ancoli-Israel S, Loredo J, Ziegler M, Dimsdale J . The roles of TNF-alpha and the soluble TNF receptor I on sleep architecture in OSA. Sleep Breath. 2009; 13(3):263-9. PMC: 2698981. DOI: 10.1007/s11325-008-0242-2. View

Tsai T, Wang T, Hung S, Tsai P, Schenkel B, Zhang M . Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan. J Dermatol Sci. 2011; 63(1):40-6. DOI: 10.1016/j.jdermsci.2011.03.002. View

Hashmi S, Zeng Q . Role of interleukin-17 and interleukin-17-induced cytokines interleukin-6 and interleukin-8 in unstable coronary artery disease. Coron Artery Dis. 2006; 17(8):699-706. DOI: 10.1097/01.mca.0000236288.94553.b4. View

Gupta M, Gupta A . Psoriasis Is Associated With a Higher Prevalence of Obstructive Sleep Apnea and Restless Legs Syndrome: A Possible Indication of Autonomic Activation in Psoriasis. J Clin Sleep Med. 2018; 14(6):1085. PMC: 5991957. DOI: 10.5664/jcsm.7194. View

Minoguchi K, Tazaki T, Yokoe T, Minoguchi H, Watanabe Y, Yamamoto M . Elevated production of tumor necrosis factor-alpha by monocytes in patients with obstructive sleep apnea syndrome. Chest. 2004; 126(5):1473-9. DOI: 10.1378/chest.126.5.1473. View

Kabeloglu Ilbay V, Tas B, Altuntas M, Atakli H, Soysal A . Risk of Obstructive Sleep Apnea Syndrome in Psoriasis Patients. Arch Iran Med. 2019; 22(3):137-143. View

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

10.

Griffiths C, Iaccarino L, Naldi L, Olivieri I, Pipitone N, Salvarani C . Psoriasis and psoriatic arthritis: immunological aspects and therapeutic guidelines. Clin Exp Rheumatol. 2006; 24(1 Suppl 40):S72-8. View

11.

Cohen J, Jackson C, Li T, Wu S, Qureshi A . Sleep disordered breathing and the risk of psoriasis among US women. Arch Dermatol Res. 2015; 307(5):433-8. DOI: 10.1007/s00403-015-1536-4. View

12.

Kaczmarek E, Bakker J, Clarke D, Csizmadia E, Kocher O, Veves A . Molecular biomarkers of vascular dysfunction in obstructive sleep apnea. PLoS One. 2013; 8(7):e70559. PMC: 3726633. DOI: 10.1371/journal.pone.0070559. View

13.

Higgins J, Thompson S . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186. View

14.

Lu D, Li N, Yao X, Zhou L . Potential inflammatory markers in obstructive sleep apnea-hypopnea syndrome. Bosn J Basic Med Sci. 2016; 17(1):47-53. PMC: 5341778. DOI: 10.17305/bjbms.2016.1579. View

15.

Nestle F, Kaplan D, Barker J . Psoriasis. N Engl J Med. 2009; 361(5):496-509. DOI: 10.1056/NEJMra0804595. View

16.

Gabryelska A, Bialasiewicz P . Is Autonomic Activation a Middleman Between Obstructive Sleep Apnea Syndrome and Psoriasis?. J Clin Sleep Med. 2018; 14(6):1087-1088. PMC: 5991940. DOI: 10.5664/jcsm.7196. View

17.

STROBEL R, Rosen R . Obesity and weight loss in obstructive sleep apnea: a critical review. Sleep. 1996; 19(2):104-15. DOI: 10.1093/sleep/19.2.104. View

18.

Vgontzas A . Does obesity play a major role in the pathogenesis of sleep apnoea and its associated manifestations via inflammation, visceral adiposity, and insulin resistance?. Arch Physiol Biochem. 2008; 114(4):211-23. DOI: 10.1080/13813450802364627. View

19.

Hirotsu C, Nogueira H, Albuquerque R, Tomimori J, Tufik S, Andersen M . The bidirectional interactions between psoriasis and obstructive sleep apnea. Int J Dermatol. 2015; 54(12):1352-8. DOI: 10.1111/ijd.13026. View

20.

Papadavid E, Vlami K, Dalamaga M, Giatrakou S, Theodoropoulos K, Gyftopoulos S . Sleep apnea as a comorbidity in obese psoriasis patients: a cross-sectional study. Do psoriasis characteristics and metabolic parameters play a role?. J Eur Acad Dermatol Venereol. 2012; 27(7):820-6. DOI: 10.1111/j.1468-3083.2012.04580.x. View