Frequency of obstructive sleep apnea in patients diagnosed as rheumatoid arthritis

Aim: The aim of the study was to investigate the frequency of obstructive sleep apnea (OSA) in rheumatoid arthritis (RA) patients and the factors that may cause OSA development in RA patients. Patients and methods: Epworth sleepiness scale (ESS), STOP-BANG questionnaires were applied and polysomnography (PSG) was performed to evaluate OSA in patients diagnosed with RA by the Physical Therapy and Rehabilitation outpatient clinic or the Rheumatology outpatient clinic. Results: 83 RA patients participated in our study. 78.3% of the patients were female, 21.7% were male, and the average age was 57. PSG was performed in 16 patients who met at least 2 of the following criteria: snoring, witnessed apnea, daytime sleepiness, body mass index ≥ 35 kg/m2 and ESS ≥ 10. OSA was found in 87.5% of patients who underwent PSG. Patients diagnosed with OSA were 16.8% of all patients included in the study. Weight, BMI, waist circumference and neck circumference measurements were significantly different in patients with OSA. The sensitivity and negative predictive value of snoring for OSA were 100%. The snoring complaint was found to have a high capacity to differentiate the patient population. Witnessed apnea and daytime sleepiness were found to have a higher capacity to distinguish the healthy population. The medications used by the patients were questioned. The frequency of OSA was significantly higher in patients using MTX. Conlusion: By identifying the risk factors for OSA, OSA can be diagnosed early in RA and treatment can be started. Early treatment may help to reduce possible comorbidities, morbidity and mortality. Conducting studies on a larger population will help to define the conditions that cause RA and OSA together and initiate early treatment. Keyword: Rheumatoid arthritis, obstructive sleep apnea, polysomnography, STOP-BANG