Clinical and polysomnographic evaluation of sleep breathing disorders in patients with sarcoidosis

Aim: The aim of the study was to evaluate the frequency of obstructive sleep apnea syndrome (OSAS) in sarcoidosis patients and the clinical factors that effect it. Patients and methods: Epworth Sleepiness Scale, Stanford Sleepiness Scale, Pittsburgh Sleep Quality Scale, Berlin questionnaire, STOP and STOPBANG questionnaires were performed on 60 consecutive sarcoidosis patients in our clinic and polysomnography (PSG) test was performed to evaluate the risk of sleep OSAS. Results: A total of 60 sarcoidosis patients, 45 (75%) women and 15 (25%) men with an average age of 50±11, were included in the study. 54 of the cases were polysomnographed. In 70.4% (38/54) of polysomnographed cases, OSAS were diagnosed. The mean age was higher in sarcoidosis patients with OSAS (47±13 vs. 54±11, p=0.041). Sarcoidosis patients with OSAS were fatter (BMI 29.0±4.6 vs. 31.9±4.4 p=0.034). The frequency of OSAS with polysomnography was significantly higher in patients with clinically high risk sarcoidosis in the Pittsburgh sleep quality scale, STOP and stop-BANG surveys (P=0.024, p<0.001 and p<0.001, respectively). In sarcoidosis patients with polysomnography, OSAS were detected in 38.5% (5/13) in Stage 1, 77.8% (28/36) in Stage 2, and in all cases (5/5) in Stage 3. The frequency of OSAS was found to increase as sarcoidosis phase increased (p=0.003). As the sarcoidosis phase increased, the mean of the apnea hypopnea index (AHI) also increased statistically significantly (p=0.043). AHI was found to be positively correlated with sarcoidosis stage (p=0.003, r=0.391). The rates of OSAS were statistically significantly higher in patients with sarcoidosis who were treated than those who had never been treated. (87.5% vs. 56.7%, p=0.018). Multivariant logistic regression analysis found that the only independent risk factor that increased the risk of OSAS in sarcoidosis cases was the stage of the disease (p=0.026). Conlusion: High rates of OSAS were detected in sarcoidosis, which increased with the stage of the disease. We believe that sarcoidosis patients with advanced age, obesity, steroid treatment and lung parenchyma involvement (stages 2 and 3) should be evaluated clinically and polysomnographically in terms of OSAS risk. Larger and comprehensive studies are needed to establish the possible causes of high OSAS prevalence in sarcoidosis. Keywords: Sarcoidosis, obstructive sleep apnea, polysomnography, sleep questionnaires