# The prevalence of high risk of obstructive sleep apnea in patients with psoriasis

## TL;DR

This study found that over half of psoriasis patients are at high risk for obstructive sleep apnea, especially men and those with hypertension.

## Contribution

The study identifies a high prevalence of OSA risk in psoriasis patients and highlights key risk factors like male sex and hypertension.

## Key findings

- 54% of psoriasis patients were identified as high-risk for OSA.
- Male sex, hypertension, and elevated ESS scores were significantly associated with increased OSA risk.
- Psoriasis characteristics were not significantly correlated with OSA risk.

## Abstract

To determine the prevalence of high-risk OSA among people diagnosed with psoriasis and to investigate relationships between the risk of OSA and the characteristics of psoriasis.

This cross-sectional study was conducted after the approval of the review board during February 2023 and February 2024. Inclusion criteria were psoriasis patients aged ≥ 18 years who visited the dermatologic clinic, Siriraj Hospital, Thailand. Demographic data, anthropometric measurements, underlying conditions, types of psoriasis, Psoriasis Area and Severity Index scores, disease duration, percentage of body surface area involvement, Epworth Sleepiness Scale (ESS), and STOP-Bang questionnaire were collected. Patients who were unable to answer these questionnaires were excluded.

Of the 200 participants (106 men, 94 women), 108 patients (54%) were identified as high-risk for OSA; of them, 70 were men (64.8%) and 38 were women (35.2%). Within this group, statistically significant differences were observed in male (p < 0.001), age (p = 0.02), and the presence of hypertension, diabetes, and dyslipidemia. Both BMI and an ESS score > 10 were also significantly elevated in the high-risk group (p < 0.05). However, no significant correlations were detected between various characteristics of psoriasis and the risk of OSA. Only male sex [adjusted odd ratios (OR) = 3.51], HT (OR = 2.87), and an ESS score > 10 (OR = 4.13), showed statistically significant associations with an increased risk of OSA (p < 0.05).

Psoriasis patients had a higher prevalence of high-risk OSA compared to the general Thai population. This underscores the importance of screening individuals with psoriasis, particularly those exhibiting concurrent HT, male sex, and EDS, for OSA.

The online version contains supplementary material available at 10.1007/s11325-025-03318-y.