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

Tzong-Yun Ger,Ching-Chi Chi,Yun Fu

doi:10.1038/s41598-020-62834-x

Tzong-Yun Ger, Ching-Chi Chi + Show 1 more

Open Access

https://doi.org/10.1038/s41598-020-62834-x

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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.

Highlights

Obstructive sleep apnea (OSA), called obstructive sleep apnea-hypopnea syndrome, is a chronic disorder of intermittent upper airway collapse during sleep resulting in recurrent hypoxia[12,13]
Two case control studies, and one cross-sectional study investigated the association of psoriasis with OSA
Three cohort studies and one case-control study investigated the association of OSA with psoriasis

Summary

Introduction

Obstructive sleep apnea (OSA), called obstructive sleep apnea-hypopnea syndrome, is a chronic disorder of intermittent upper airway collapse during sleep resulting in recurrent hypoxia[12,13]. OSA induces systemic inflammatory and increases the risk of hypertension, stroke, cardiovascular disease, and metabolic disorder, in particular of diabetes mellitus type 2 and metabolic syndrome regardless of the obesity[15,16,17]. The association between psoriasis and OSA has been examined in many studies but the results were limited and inconsistent[20,21,22,23,24,25,26,27].

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