Egeberg Alexander, Khalid Usman, Gislason Gunnar Hilmar, Mallbris Lotus, Skov Lone, Hansen Peter Riis
Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup.
Department of Dermato-Allergology, Herlev and Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup.
J Clin Sleep Med. 2016 May 15;12(5):663-71. doi: 10.5664/jcsm.5790.
Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis and sleep apnea.
All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression.
There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval) for sleep apnea were 1.30 (1.17-1.44), 1.65 (1.23-2.22), and 1.75 (1.35-2.26) in subjects with mild and severe psoriasis, and psoriatic arthritis, and IRRs for mild and severe psoriasis, and psoriatic arthritis in sleep apnea without continuous positive airway pressure (CPAP) therapy were 1.62 (1.41-1.86), 2.04 (1.47-2.82), and 1.94 (1.34-2.79), respectively. In patients with sleep apnea and CPAP therapy (i.e., severe sleep apnea) the IRRs were 1.82 (1.43-2.33), 3.27 (2.03-5.27), and 5.59 (3.74-8.37), respectively.
Psoriasis was associated with increased risk of sleep apnea, and sleep apnea was associated with increased risk of psoriasis. The clinical significance of this bidirectional relationship warrants further study.
银屑病和睡眠呼吸暂停与显著的发病率和死亡率相关。尽管这两种疾病都与全身炎症有关，但关于它们潜在双向关联的研究却很缺乏。我们调查银屑病与睡眠呼吸暂停之间的潜在关联。
1997年1月1日至2011年12月31日期间所有年龄在18岁及以上的丹麦公民（n = 5,522,190）在全国登记处按个体水平进行关联。计算每10,000人年的发病率（IRs），并通过泊松回归估计调整了年龄、性别、社会经济地位、吸烟史、酒精滥用、药物治疗和合并症后的发病率比（IRRs）。
轻度银屑病、重度银屑病、银屑病关节炎和睡眠呼吸暂停的发病例数分别为53,290、6,885、6,348和39,908例。轻度和重度银屑病及银屑病关节炎患者中睡眠呼吸暂停的发病率比（95%置信区间）分别为1.30（1.17 - 1.44）、1.65（1.23 - 2.22）和1.75（1.35 - 2.26），未接受持续气道正压通气（CPAP）治疗的睡眠呼吸暂停患者中轻度和重度银屑病及银屑病关节炎的发病率比分别为1.62（1.41 - 1.86）、2.04（1.47 - 2.82）和1.94（1.34 - 2.79）。在接受CPAP治疗的睡眠呼吸暂停患者（即重度睡眠呼吸暂停）中，发病率比分别为1.82（1.43 - 2.33）、3.27（2.03 - 5.27）和5.59（3.74 - 8.37）。
银屑病与睡眠呼吸暂停风险增加相关，睡眠呼吸暂停也与银屑病风险增加相关。这种双向关系的临床意义值得进一步研究。
