Risk of Obstructive Sleep Apnea in Rheumatoid Arthritis Patients: The Frequency and Associated Disease Features

Fabian Dario Sinigaglia¹, Rafael Chaparro del Moral¹, Silvia Papasidero¹, Oscar Luis Rillo¹, José Angel Caracciolo², María Alejandra Medina¹, Analia Dellepiane³, Cecilia Zaffarana⁴, Maria de los Angeles Correa⁵, Luciana Casalla⁶, Lucía Zarate⁶, Nieves Capozzi⁷, María Victoria Martire⁸, Marta Mamani⁸, Damaris Alvarez⁹, Eduardo Kerzberg⁹ and José Luis Velasco Zamora¹⁰, ¹Rheumatology Section, Hospital General de Agudos Dr. E. Tornú, Buenos Aires, Argentina, ²Rhematology Section, Hospital General de Agudos Dr. E. Tornú, Buenos Aires, Argentina, ³CEMEC, Santa Fe, Argentina, ⁴Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina, ⁵Rheumatology, Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina, ⁶Rheumatology Section, Hospital Posadas, Buenos Aires, Argentina, ⁷'Irigoyen 1418. CABA, Hospital Posadas, Buenos Aires, Argentina, ⁸Rheumatology, Hospital Bernardino Rivadavia, Buenos Aires, Argentina, ⁹Rheumatology Section, Hospital General de Agudos Dr. J. M. Ramos Mejía, Buenos Aires, Argentina, ¹⁰Reumatología al Sur, Berazategui, Argentina

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Rheumatoid arthritis (RA) and sleep apnea

Session Information

Date: Monday, November 9, 2015

Title: Rheumatoid Arthritis - Clinical Aspects Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Obstructive Sleep Apnea Syndrome (OSA) affects 2-4% of the population and it has been observed in rheumatoid arthritis (RA) patients in up to 30.8%. Besides, OSA has been determined as an independent risk factor for arterial hypertension (AHT) and has been associated with cardiovascular disease and stroke. There is little information in the literature about the relationship between this syndrome and the characteristics of RA, therefore the aim of this study is to investigate the risk of OSA in patients with RA and related factors.

Methods: We conducted a multicenter cross-sectional observational study that included consecutive RA patients (ACR 1987-ACR/EULAR 2010). Socioeconomic status, clinical data and comorbidities were recorded. OSA risk was assessed by the Berlin Sleep Apnea Questionnaire and daytime sleepiness by the Epworth Sleepiness Scale. Visual Analog Scale for pain (VAS pain), RAPID3, DAS28, HAQ-DI and Hospital Anxiety and Depression Scale (HADS A and HADS D) were also assessed. For data analysis descriptive statistics, X²test, T-Test and binary logistic regression for multivariate analysis were applied, using OSA risk as dependent variable.

Results: Of 168 RA patients, OSA high risk was observed in 71 patients (42%) and daytime sleepiness in 50 patients (29.7%). Patients with high OSA risk showed higher BMI (29 ± 5 vs 26 ± 5, p <0.001), higher disease activity [DAS28 (4.5 ± 1.4 vs 3.7 ± 1.2, p <0.001) and RAPID3 (14 ± 7 vs 10 ± 6, p <0.002)], and worse functional capacity [HAQ (1.3 ± 0.7 vs 0.9 ± 0.7, p <0.01)]. The frequency of AHT was higher among patients with high OSA risk (42% vs 19%, p <0.002), as well as with daytime sleepiness (43% vs 25%, p <0.02), anxiety and depression disorders [HAD-A (9.2±4 vs 6.5 ± 4, p<0.001) and HAD-D (7.5±3 vs 5.4 ± 3, p<0.001)] than the low OSA risk group. In multivariate anaIysis, the independently variables associated with high OSA risk were BMI (OR 1.14, 95%CI: 1.052-1.235, p = 0.001) and DAS28 (OR 1.13, 95%CI: 1.006-2.459, p = 0.047).

Conclusion:

The risk of OSA was 42% in patients with RA and was associated with BMI and disease activity.

Disclosure: F. D. Sinigaglia, None; R. Chaparro del Moral, None; S. Papasidero, None; O. L. Rillo, None; J. A. Caracciolo, None; M. A. Medina, None; A. Dellepiane, None; C. Zaffarana, None; M. D. L. A. Correa, None; L. Casalla, None; L. Zarate, None; N. Capozzi, None; M. V. Martire, None; M. Mamani, None; D. Alvarez, None; E. Kerzberg, None; J. L. Velasco Zamora, None.

To cite this abstract in AMA style:

Sinigaglia FD, Chaparro del Moral R, Papasidero S, Rillo OL, Caracciolo JA, Medina MA, Dellepiane A, Zaffarana C, Correa MDLA, Casalla L, Zarate L, Capozzi N, Martire MV, Mamani M, Alvarez D, Kerzberg E, Velasco Zamora JL. Risk of Obstructive Sleep Apnea in Rheumatoid Arthritis Patients: The Frequency and Associated Disease Features [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/risk-of-obstructive-sleep-apnea-in-rheumatoid-arthritis-patients-the-frequency-and-associated-disease-features/. Accessed .

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