Abstract
This study aimed to evaluate the frequency of obstructive sleep apnea (OSA) in patients withsarcoidosis and related clinical factors. Consecutive patients diagnosed with sarcoidosis in our clinic were evaluated for OSA risk during sleep using theEpworth Sleepiness Scale, Stanford Sleepiness Scale, Pittsburgh Sleep Quality Index, Berlin questionnaire, STOP and STOP-BANG questionnaires, and polysomnography (PSG). A total of 60 sarcoidosis patients (mean age: 50 ± 11years, 45 (75%) women) were included in the study. Polysomnography was performed in 54 cases and revealed the diagnosis of OSA in 70% (38/54) of the patients. The mean age was higher in patients withsarcoidosis and OSA (54±11 vs.47 ± 13, p = 0.041) and body mass index values were significantly higher as well (31.9±4.4 vs,29.0 ± 4.6kg/m2, p = 0.034). Polysomnography revealed ahigher rate of OSA in patients with sarcoidosis who hadhigh-risk scores in Pittsburgh Sleep Quality Index, STOP questionnaire, and STOP-BANG questionnaire (p = 0.024, p < 0.001, and p < 0.001, respectively). Based on polysomnography, OSA was detected in 39% (5/13) with stage 1sarcoidosis, 78% (28/36) with stage 2, and in all cases (5/5) with stage 3. OSA frequency and apnea-hypopnea index (AHI) were determined to increase with advanced sarcoidosis stage (p = 0.003, p = 0.043, respectively). AHI was positively correlated with sarcoidosis stage (p = 0.003, r = 0.391). The prevalence of OSA was significantly higher in patients receiving treatment compared to treatment-naïve patients (88% vs. 57%, p = 0.018). Multivariate logistic regression analysis revealed the stage of the disease (p = 0.026) to be the single independent risk factor associated with increased risk of OSA in patientswith sarcoidosis. High rates of OSA were detected in sarcoidosis, increasing with the advanced disease stage. The findings suggest that patients with sarcoidosis andadvanced age, obesity, steroid treatment, and involvement of lung parenchyma (stages 2 and 3) should be evaluated for OSA risk. Further investigations are needed to establish the potential causes of thehigh prevalenceof OSA in sarcoidosis.
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