Psoriasis and sleep apnea share a common link — inflammation. The scaly rash and skin plaques associated with psoriasis and the joint pain linked to psoriatic arthritis are caused by inflammation. In sleep apnea, the repeated collapse of the airways leads to oxygen deficiency that can trigger inflammation.
This close connection led researchers to investigate the relationship between psoriasis and sleep apnea to determine whether they could find a link between the two conditions. Their findings were published in the Journal of Clinical Sleep Medicine in 2016.
The study analyzed data collected from all Danish citizens over the age of 18 (a total of 5.5 million people) between 1997 and 2011. Individuals who collected their second prescription of the favored psoriasis treatment in Denmark (topical vitamin D derivatives) or who received a consultation for psoriasis or psoriatic arthritis were classified as having psoriasis. Those who received a treatment consistent with severe forms of the condition (including biologic drugs, retinoids, cyclosporine, methotrexate, and psoralens) were classified as having severe psoriasis.
During the study:
- 53,290 individuals developed mild psoriasis
- 6,885 individuals developed severe psoriasis
- 6,348 individuals developed psoriatic arthritis
Those who received a first diagnosis of sleep apnea during the study period were classified as having sleep apnea. Data on continuous positive airway pressure (CPAP) use and CPAP adherence was also collected. A total of 39,908 individuals developed sleep apnea during the study period.
Sleep apnea risk in patients with psoriasis
The study found an increased risk of sleep apnea in patients with psoriasis and psoriatic arthritis. The highest incidence rates of sleep apnea were found in those between ages 40 and 50. Among those under the age of 60, sleep apnea incidence also increased as psoriasis severity increased.
Psoriasis risk in patients with sleep apnea
The study found that incidence rates of psoriasis were higher among patients with sleep apnea across all age groups. Furthermore, an increased risk of psoriasis was found among these patients regardless of whether they underwent CPAP therapy.
A two-way relationship
This study suggested that there is a bidirectional relationship between psoriasis and sleep apnea. In other words, psoriasis may increase sleep apnea risk and sleep apnea may increase psoriasis risk.
The authors of the study suggested that systemic inflammation may explain the link between the two conditions. Researchers also pointed out that diabetes has been strongly linked to both sleep apnea and psoriasis.
What this all means
If you have psoriasis and have any concerns about your sleep, speak with your doctor — particularly if you recognize any of the following symptoms of sleep apnea:
- Frequent snoring
- Pauses in breathing at night
- Gasping or choking during the night
- Morning headaches, dry mouth, or sore throat
- Mood swings, irritability, or difficulty concentrating
It is also important to take action when it comes to treating your psoriasis — work with your doctor to create treatment goals, try to reduce stress, and stay active.
If you have sleep apnea, speak with your doctor if you notice any of the common symptoms of psoriasis and psoriatic arthritis such as:
- Joint pain
- Dry, flaky skin
- Peeling, itchy skin
- Skin redness or scaling
If you have been prescribed CPAP therapy, try to stick with it — or talk to your doctor about alternative treatment options, including exercise or perhaps even a tonsillectomy.