Do RA Patients Have a Higher Risk for Sleep Apnea? | Arthritis Information

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  1. Address correspondence to Dr. S.E. Gabriel, Department of Health Sciences Research, Mayo Foundation, 200 First Street SW Rochester, MN 55905. E-mail: gabriel@mayo.edu

Abstract

Objective. Patients with rheumatoid arthritis (RA) have an increased risk for developing cardiovascular disease (CVD) compared to subjects in the general population. The development of CVD has also been linked to chronic sleep apnea. The purpose of this study was to examine the risk for sleep apnea in patients with RA compared to subjects without RA.

Methods. We recruited RA patients and non-RA subjects who were age and sex matched from the same population. These persons completed the Berlin Sleep Questionnaire, which evaluated their level of risk (high or low) for sleep apnea. In addition, there were 3 subscales evaluating snoring, fatigue, and relevant comorbidities [i.e., high blood pressure and obesity [body mass index (BMI) ≥ 30 kg/m2)]. Chi-squared tests were used for comparisons.

Results. The study population consisted of 164 patients with RA and 328 patients without RA. Age, sex and BMI were similar for both groups. There was no difference in snoring (p = 0.31) or in the comorbidities subscale (p = 0.37). However, RA patients reported more fatigue (38%) than subjects without RA (13%; p < 0.001). Overall, the risk for sleep apnea was significantly higher for the RA patients (50%) than the non-RA subjects (31%; p < 0.001).

Conclusion. Patients with RA may be at a higher risk for sleep apnea compared to non-RA subjects. This apparent risk difference may be attributed to reports of fatigue in RA patients, which may be associated with sleep apnea or RA disease itself.

http://jrheum.org/content/36/9/1869.abstract
I wonder how many chronic conditions are a result of years of obstructive sleep apnea. I'm surprised at the number of people that come in to the hospital with this. and how many are on CPAP at night. It is nice that this problem is being recognized by our doctors and treated aggressively. [QUOTE=SnowOwl]

Do rheumatologists recognize sleep apnea as something for their office to treat, or do they believe an RAer with that particular problem should see a different specialist for therapies?

[/QUOTE]
I have no idea Snow.  I think it would all depend on the RD.  My Rd is in a large practice with internal med docs, so perhaps that would make a difference.  I just don't know... Common sense tells me that RA patients are more prone to sedentary life styles, which results in added weight, which can result in sleep apnea.
 
Consider, too, that some patients have inflammation around the cervical spine which I imagine could lead to sleep apnea.
Snow, in my area, the Pulmonologist treats sleep apnea.  I don't know if this is the same everywhere.  I wonder if Sjogren's would contribute?  I mean, the additional dryness seem like it would promote snoring, no?

It's the Otolaryngology, Head and Neck specialists in my area.
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