Abstract
BackgroundObstructive sleep apnea (OSA) is associated with systemic inflammation and induces various comorbid medical diseases. To date, no study has explored the relationship between OSA and atopic dermatitis (AD), an inflammatory and autoimmune skin disorder. This study investigated the longitudinal risk for AD in patients with OSA.MethodsA random sample of 1,000,000 individuals from Taiwan's National Health Insurance database was collected. From this sample, 1222 patients with newly-diagnosed OSA between 2000 and 2005 were identified and compared with a matched cohort of 18330 patients without OSA. All patients were tracked for 5.5 years from the index date in order to identify which patients subsequently developed AD.ResultsDuring the 5.5-year follow-up period, the incidence rates of AD in the OSA cohort and comparison groups were 9.81 and 6.21 per 1000 person-years, respectively. After adjustment for age, gender, diabetes, hypertension, coronary heart disease, obesity, allergy, allergic rhinitis, asthma, monthly income, and geographic location, patients with OSA were 1.5-times more likely to develop AD than patients without OSA (95% CI = 1.15–1.95, p = 0.0025). The hazard risk for AD was greater in male OSA patients and young OSA patients (0–18 and 19–34 years), adjusted HRs being 1.53 (95% CI = 1.14–2.06, p = 0.005), 4.01(95% CI = 1.57–10.26, p = 0.0038) and 1.75(95% CI = 1.00–3.04, p = 0.0483), respectively. The log-rank test indicated that OSA patients <35-years-old had significantly higher cumulative incidence rates of AD than those patient of the same age in the comparison group (p = 0.0001).ConclusionPatients with OSA, especially male patients and younger patients, are at an increased risk for AD later in life.
Highlights
Atopy is defined as a condition that involves hyperreactivity to allergic triggers
A total of 1222 Obstructive sleep apnea (OSA) patients and 18330 age, gender, and index datematched non-OSA patients were followed for 5.5 years
Patients with OSA had a higher prevalence of diabetes mellitus (DM), hypertension (HTN), coronary heart disease (CHD), obesity, allergy, allergic rhinitis, and asthma
Summary
The prevalence of atopic dermatitis (AD), a chronic inflammatory and pruritic skin disease [1], appears to be increasing, especially in industrialized counties. Not a life-threatening disease, AD negatively impacts health and quality of life and increases the medical burden. Increasing evidence suggests that AD is more than a local inflammatory disease and may be the result of systemic inflammation. Chemokines, cytokines, T-cells and other inflammatory cells appear to contribute to the initiation and maintenance of this disease [3]. Obstructive sleep apnea (OSA) is associated with systemic inflammation and induces various comorbid medical diseases. No study has explored the relationship between OSA and atopic dermatitis (AD), an inflammatory and autoimmune skin disorder. This study investigated the longitudinal risk for AD in patients with OSA
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