What question did this study set out to answer?

This research aims to evaluate the prevalence of obstructive sleep apnea (OSA) and its associations with disease activity, functional impairment, and comorbidities in patients with psoriatic arthritis (PsA).

February 26, 2026Open Access

Obstructive Sleep Apnea in Psoriatic Arthritis: Clinical Characteristics and Comorbidities

Key Points

This research aims to evaluate the prevalence of obstructive sleep apnea (OSA) and its associations with disease activity, functional impairment, and comorbidities in patients with psoriatic arthritis (PsA).
Conducted a cross-sectional analysis of 247 consecutive PsA patients.
Diagnosed OSA through review of medical records.
Assessed disease activity using cDAPSA and ASDAS-CRP metrics.
Measured functional disability with HAQ-DI and BASFI.
Evaluated sleep quality and psychological symptoms using PSQI and HADS.
Found OSA prevalence at 8.9% among PsA patients.
Patients with OSA exhibited higher median age, tender joint count, and functional disability compared to those without.
Higher levels of fatigue, anxiety, and depression were reported in OSA+ patients despite similar inflammatory marker levels.
Female sex and greater tender joint count were identified as independent predictors of OSA.

Abstract

Background: Obstructive sleep apnea (OSA) is increasingly recognized in chronic inflammatory diseases, yet its prevalence and clinical correlates in psoriatic arthritis (PsA) remain poorly characterized. Objective: The objective of this study was to evaluate OSA prevalence and its relationship with disease activity, functional impairment, and comorbidities in PsA patients. Methods: A cross-sectional analysis of 247 consecutive PsA patients was conducted. OSA diagnosis was determined through medical record review. Disease activity was assessed using cDAPSA and ASDAS-CRP. Functional disability was measured using HAQ-DI and BASFI. Sleep quality (PSQI) and psychological symptoms (HADS) were evaluated. Inflammatory markers included CRP, IL-6, and TNF-α. Multivariable logistic regression identified independent predictors of OSA. Results: OSA prevalence was found to be 8.9% (22/247). OSA+ patients had significantly higher median age (58.0 vs. 54.0 years, p = 0.02), tender joint count (2.0 vs. 1.0, p = 0.002), functional disability (1.1 vs. 0.3, p = 0.001), fatigue (30.5 vs. 38.0, p = 0.04), anxiety (7.5 vs. 5.0, p = 0.03), depression (7.0 vs. 3.0, p = 0.004), and worse sleep quality (11.5 vs. 7.0, p = 0.001). Notably, no significant differences in inflammatory markers (CRP, swollen joints) were found between groups despite substantially higher pain burden in OSA+ patients. Female sex and greater tender joint count emerged as independent predictors of OSA. Conclusions: OSA occurs in ~9% of unselected PsA patients and is independently associated with functional disability, psychological distress, and elevated tender joint counts despite comparable inflammatory markers. This dissociation suggests that OSA drives pain amplification through non-inflammatory mechanisms. These findings support the use of systematic OSA screening in PsA patients with pain or disability disproportionate to inflammatory burden, particularly in those with psychological comorbidities.

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