0549: High Prevalence of Obstructive Sleep Apnea in Psoriatic Arthritis: A Polysomnography-Based Cross-Sectional Study

Background/Purpose: Background: Obstructive sleep apnea (OSA) is increasingly recognized in patients with psoriatic arthritis (PsA), yet few studies have used polysomnography (PSG)—the gold-standard diagnostic method. This study bridges this gap by employing PSG to definitively characterize OSA prevalence and its relationship with PsA disease activity.

Objective: To determine OSA prevalence in PsA using PSG and evaluate associations with disease activity.

Methods: This two-stage cross-sectional study included adult PsA patients.
Stage 1: Participants were screened using the STOP-BANG questionnaire for OSA risk and the Epworth Sleepiness Scale (ESS) for daytime sleepiness. Disease activity was assessed using DAPSA and DAS28-CRP, and functional status by HAQ.
Stage 2: All patients at high risk and a random 50% sample of low/intermediate-risk patients underwent overnight PSG. OSA was defined by apnea–hypopnea index (AHI) ≥5 events/hour and categorized as mild (5–14), moderate (15–29), or severe (≥

Results: Sixty-eight patients (69% female, mean age 46 years, mean BMI 29 kg/m²) were enrolled. Sleep-related symptoms were reported by 77% (snoring 53%, morning fatigue 68%). Mean disease activity scores: DAPSA 20±14, DAS28-CRP 2.8±1.0, HAQ 0.6±0.8. Based on STOP-BANG, 19% were high-risk, 35% intermediate, and 46% low-risk. PSG was performed in 42 patients (all high-risk and selected low/intermediate-risk). OSA was confirmed in 50%: 14% mild, 19% moderate, 17% severe. The estimated prevalence of moderate-to-severe OSA in the full cohort was 36%. Higher STOP-BANG scores (OR 2.35, p = 0.016) and older age (OR 1.13 per year, p = 0.007) were significant predictors of OSA. No significant correlation was found between OSA and PsA disease activity or comorbidities.

Conclusion: OSA is highly prevalent among PsA patients, with 50% testing positive by PSG. Despite this burden, OSA showed no association with disease activity. Routine screening and early sleep specialist referral for at-risk PsA patients may improve recognition and management. Further longitudinal, multicenter studies are needed to explore the role of psoriasis severity and treatment effects on OSA risk.