Table 1.
Characteristics of included studies.
| First author, year, country | Study design | Case group | Control group | Case definition and sampling population/outcome definition | Results | |
|---|---|---|---|---|---|---|
| Studies investigating the odds of obstructive sleep apnea in psoriasis patients | ||||||
| Tsai, 2011, Taiwan | Case-control | 51,800 patients with psoriasis (31,923 males and 19,877 females) | 207,200 age-, gender- and urbanization- matched controls (127,692 males and 79,508 females) | ICD-9-CM psoriasis code from national health insurance database in 2006/ICD-9-CM sleep apnea code | Crude OR: 3.30 (2.00–5.44) | Adjusted RR: 3.89 (2.26–6.71) |
| Shalom, 2016, Israel | Case-control | 12,336 patients with psoriasis (6,441 males and 5,895 females) | 24,008 age- and sex- matched controls (12,096 males and 11,912 females) | Diagnosis of psoriasis by dermatologists from medical database of Clalit Health Services/ICD-9-CM sleep apnea code | OR:1.74 (1.50–2.03) | Adjusted OR: 1.27 (1.08–1.49) |
| Egeberg, 2016, Denmark | Cohort study | 66,523 patients with psoriasis (32,115 males and 34,408 females) | 5,393,040 individuals in the reference population (2,659,620 males and 2,733,420 females) | ICD-10-CM psoriasis or psoriatic arthritis code from Danish National Patient Register from 1 Jan 1997 to 31 Dec 2011/ICD-10-CM sleep apnea code |
IRR: Mild psoriasis: 1.88 (1.69–2.09) Severe psoriasis: 2.69 (2.00–3.62) Psoriatic arthritis: 3.08 (2.38–4.00) |
Adjusted IRR: Mild psoriasis: 1.36 (1.21–1.53) Severe psoriasis: 1.53 (1.08–2.18) Psoriatic arthritis: 1.98 (1.50–2.61) |
| Sacmaci, 2019, Turkey | Cross-sectional | 60 patients with psoriasis (30 males and 30 females) | 60 sex- and age- matched controls (30 males and 30 females) | Diagnosis of psoriasis by dermatologists//Diagnosis of sleep apnea by neurologists according to Berlin Questionnaire for Sleep Apnea | Crude OR: 6 (1.89–19.04) | NA |
| Studies investigating the odds of psoriasis in obstructive sleep apnea patients | Crude (95% CI) |
Adjusted (95% CI) |
||||
| Yang, 2012, Taiwan | Cohort study | 2,258 patients with sleep apnea (1,414 males and 844 females) | 11,255 age- and sex-matched controls without sleep apnea and psoriasis | ICD-9-CM sleep apnea codes from national health insurance database from 1 Jan 2001 to 31 Dec 2005 after receiving polysomnography/Two consensus psoriasis diagnosis, with at least one made by dermatologist or rheumatologists | Crude HR: 2.21 (1.08–4.49) | Adjusted HR: 2.30(1.13–4.69) |
| Cohen, 2015, USA | Cohort study | 490 patients with OSA (All females) | 71,108 individuals in the reference population (All females) | Self-reported sleep apnea in 1997/Self-reported psoriasis, psoriasis within 2 years of onset of sleep apnea were excluded |
Crude IRR: 2.65 (1.6–4.14) |
Adjusted RR: 1.91(1.20–3.05) |
| Egeberg, 2016, Denmark | Cohort study | 39,908 patients with sleep apnea (31503 males and 8405 females) | 5,419,655 individuals in the reference population (2,660,232 males and 2,759,423 females) | ICD-10-CM sleep apnea code from Danish National Patient Register from 1 Jan 1997 to 31 Dec 2011/ICD-10-CM psoriasis or psoriatic arthritis code |
IRR: Sleep apnea without CPAP Mild psoriasis: 1.97 (1.71–2.26) Severe psoriasis: 2,80 (2.02–3.87) Psoriatic arthritis: 2.38 (1.65–3.34) Sleep apnea with CPAP Mild psoriasis: 2.29 (1.79–2.93) Severe psoriasis: 4.77 (2.96–7.67) Psoriatic arthritis: 7.29 (4.88–10.88) |
Adjusted IRR: Sleep apnea without CPAP Mild psoriasis: 1.62 (1.38–1.89) Severe psoriasis: 1.85 (1.25–2.74) Psoriatic arthritis: 1.98 (1.32–2.99) Sleep apnea with CPAP Mild psoriasis: 1.95 (1.48–2.57) Severe psoriasis: 3.75 (2.22–6.34) Psoriatic arthritis: 6.84 (4.49–10.4) |
| Papadavid, 2017, Greece | Case-control | 253 patients with OSA (200 males and 53 females) | 104 controls without OSA (82 males and 22 females) | Underwent full nocturnal polysomnography, cessation of airflow for ≥10 s, from July 2009 to July 2012/Diagnosed for psoriasis by the same dermatologist | NA | Adjusted OR: 13.31 (1.19–48.93) |
CI, confidence interval; CM, Clinical Modification; HR, hazard ratio; ICD, International Classification of Disease; IRR, incidence rate ratio; N/A, not available; OR, odds ratio; OSA, obstructive sleep apnea; RR, risk ratio.