Women with sleep apnea may have an increased risk for psoriasis, according to new research published in the Archives of Dermatological Research.
Although researchers investigated both snoring and obstructive sleep apnea, the findings, derived over 11 years from more than 71,000 women, indicated a link between obstructive sleep apnea–hypopnea syndrome, known as simply sleep apnea, and incident psoriasis. This link was not present for patients who snored.
The prospective study included 71,598 women from 1997 to 2008 as part of the Nurses’ Health Study. Each of the participants received follow-up questionnaires every 2 years that asked about snoring, diagnosis of sleep apnea, and diagnosis of psoriasis and psoriatic arthritis (PsA). The researchers then focused on patients who reported having snoring and sleep apnea before diagnosis of psoriasis or PsA.
Over the follow-up period, there were 524 cases of psoriasis. The age-adjusted relative risk (RR) of psoriasis among women with sleep was 2.19 (95 % CI 1.39–3.45), the multivariate RR was 1.93 (95 % CI: 1.21–3.08).
After adjusting for other conditions that are associated with psoriatic disease, including night shift work, cardiovascular disease, and type 2 diabetes, as well as other factors that might lead to sleep apnea, the researchers found that women with sleep apnea had nearly double the risk of developing psoriasis compared with women without sleep apnea (multivariate RR 1.91 [95 % CI 1.20–3.05]). However the presence of snoring was not associated with a higher risk of psoriasis.
Although women with sleep apnea were more likely to have a higher body mass index, hypertension and cardiovascular disease, and type 2 diabetes (P<0.001 for all), there was no effect modification by BMI (P=0.52), hypertension (P = 0.34), or snoring (P=0.91). Sleep apnea was not associated with an increased risk of PsA.