Skip to main content
Log in

Increased frequency of obstructive sleep apnea in the patients with systemic sclerosis

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Introduction

Sleep problems, including obstructive sleep apnea (OSA), profoundly affect quality of life in patients with systemic sclerosis (SSc). This study aimed to determine the prevalence of OSA in patients with SSc and the factors affecting OSA.

Methods

Consecutive patients with SSc lung involvement who were referred to the “Outpatient Service for Interstitial Lung Disease” in our university hospital between 2015 and 2017 were included in the study. All patients completed the Epworth Sleepiness Scale (ESS) and underwent examination including body mass index (BMI), measurement of waist circumference, upper respiratory tract examination, and polysomnography (PSG). Spirometry, carbon monoxide diffusion test (DLCO), and 6-min walking distance were also performed.

Results

Of 38 patients, mean age 51.3 ± 11.6 years, 35 were women (92%). Mean apnea-hypopnea index (AHI) was 11 ± 15 (median 5.5) and prevalence of OSA was 58%. Mild OSA was found in 13 (34%) of patients, moderate OSA in 6 (16%), and severe OSA in 3 (8%). Significant relationships were found between age (p = 0.02), waist circumference (p = 0.01), presence of witnessed apneas (p = 0.005), and presence of OSA.

Conclusions

Compared with the general population, the prevalence of OSA is increased in women with SSc. Patients with older age, those with increased waist circumference, and those reporting witnessed apneas should be studied for OSA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mayes MD, Klippel J, Stone J, Crafford L, White P (2008) Systemic Sclerosis. In: Systemic sclerosis: A. Clinical features. Primer on the rheumatic diseases. Springer and Arthritis Foundation (pg. 343–50), New York

    Google Scholar 

  2. Pihtili A, Bingol Z, Kiyan E, Cuhadaroglu C, Issever H, Gulbaran Z (2013) Obstructive sleep apnea is common in patients with interstitial lung disease. Sleep Breath 17(4):1281

    Article  Google Scholar 

  3. Cao MT, Guilleminault C, Kushida CA (2011) Clinical features and evaluation of obstructive sleep apnea and upper airway resistance syndrome. In: Kryger MH, Roth T, Dement WC (eds) Principles and practice of sleep medicine, 5th edn, St. Louis, pp 1206–1218

  4. Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, Hamilton GS, Dharmage SC (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34:70–81

    Article  Google Scholar 

  5. Bassel M, Hudson M, Taillefer SS, Schieir O, Baron M, Thombs BD (2011) Frequency and impact of symptoms experienced by patients with systemic sclerosis: results from a Canadian National Survey. Rheumatology 50(4):762–767

    Article  Google Scholar 

  6. Milette K, Hudson M, Körner A, Baron M, Thombs BD, Canadian Scleroderma Research Group (2013) Sleep disturbances in systemic sclerosis: evidence for the role of gastrointestinal symptoms, pain and pruritus. Rheumatology (Oxford). 52(9):1715–1720

    Article  Google Scholar 

  7. Milette K, Razykov I, Pope J, Hudson M, Motivala SJ, Baron M, Thombs BD (2011) Clinical correlates of sleep problems in systemic sclerosis: the prominent role of pain. Rheumatology (Oxford) 50(5):921–925

    Article  Google Scholar 

  8. Prado GF, Allen RP, Trevisani VM, Toscano VG, Earley CJ (2002) Sleep disruption in systemic sclerosis (scleroderma) patients: clinical and polysomnographic findings. Sleep Med 3:341–345

    Article  Google Scholar 

  9. Frech T, Hays RD, Maranian P, Clements PJ, Furst DE, Khanna D (2011) Prevalence and correlates of sleep disturbance in systemic sclerosis-results from the UCLA scleroderma quality of life study. Rheumatology (Oxford) 50(7):1280–1287

    Article  Google Scholar 

  10. Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. J Clin Sleep Med 8(5):597–619

    Article  Google Scholar 

  11. Stradling JR (1995) Sleep-related breathing disorders. Obstructive sleep apnoea: definitions, epidemiology, and natural history. Thorax 50:683–689

    Article  CAS  Google Scholar 

  12. Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V, Preisig M, Malhotra A, Waeber G, Vollenweider P, Tafti M, Haba-Rubio J (2015) Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 3(4):310–318

    Article  CAS  Google Scholar 

  13. Lim YH, Choi J, Kim KR, Shin J, Hwang KG, Ryu S, Cho SH (2014) Sex-specific characteristics of anthropometry in patients with obstructive sleep apnea: neck circumference and waist-hip ratio. Ann Otol Rhinol Laryngol 123(7):517–523

    Article  Google Scholar 

  14. Lancaster LH, Mason WR, Parnell JA, Rice TW, Loyd JE, Milstone AP, Collard HR, Malow BA (2009) Obstructive sleep apnea is common in idiopathic pulmonary fibrosis. Chest. 136:772–778

    Article  Google Scholar 

  15. Mermigkis C, Chapman J, Golish J, Mermigkis D, Budur K, Kopanakis A, Polychronopoulos V, Burgess R, Foldvary-Schaefer N (2007) Sleep-related breathing disorders in patients with idiopathic pulmonary fibrosis. Lung. 185:173–178

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sermin Borekci.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty Institutional Board) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gundogdu, S., Borekci, S., Atahan, E. et al. Increased frequency of obstructive sleep apnea in the patients with systemic sclerosis. Sleep Breath 25, 237–242 (2021). https://doi.org/10.1007/s11325-020-02080-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-020-02080-7

Keywords

Navigation