Rheumatoid Arthritis Increases Risk Of Obstructive Sleep Apnoea

The risk of developing obstructive sleep apnoea (OSA) is higher among individuals with rheumatoid arthritis (RA) than those without the disease, according to a study published in BMJ.For the retrospective cohort analysis, investigators used reimbursement claims data from the Longitudinal Health Insurance database for Catastrophic Illness Patients (LHID-CIP)––which is part of the National Health Insurance Research Database (NHIRD) of Taiwan––to compare the risk of OSA between patients with RA and those without.The Cox proportion hazards regression analysis was used to calculate the HRs of OSA.The incidence rates of OSA were higher in males than females, and in patients with any selected comorbidity, than in those without the comorbidity. In the multivariable model analyses, the risk of OSA was 4.19-fold higher in males compared with females, and was higher in patients with hyperlipidemia, IHD, and obesity.Stratified analyses by age group, and comorbidity showed that the incidence rates of OSA associated with rheumatoid arthritis were higher in all subgroups.

Limitations to the study were that investigators used the ICD-9-CM algorithm to define rheumatoid arthritis, OSA, and comorbidities; NHIRD did not provide detailed information on RA or OSA severity, nor the potential factors, such as body weight, height history of RA and/or OSA, and lifestyles, including drinking and smoking habits; relevant clinical variables, such as PSG results, image reports, and serum laboratory data, were unavailable in the study; estimates of elevated risk of OSA were most likely conservative due to the requirement for PSG to define OSA; and because of the higher overall prevalence of OSA in men, it is likely that OSA is disproportionately under-recognized in women.The results of the study suggest that patients with RA are at an increased risk of developing OSA, and it is important to evaluate sleep quality and quantity for patients with rheumatoid arthritis to detect OSA occurrence and reduce further complications, the authors concluded.