Sleep disorders and increased risk of autoimmune diseases in individuals without sleep apnea

Sleep. 2015 Apr 1;38(4):581-6. doi: 10.5665/sleep.4574.

Abstract

Study objectives: To explore the association between the non-apnea sleep disorder (NSD) and autoimmune diseases.

Design: Cohort study.

Setting: Nationwide database research.

Participants: 84,996 adult patients with NSD diagnoses recorded in the Taiwan National Health Insurance Research Database between 2000 and 2003, after excluding those with antecedent autoimmune diseases. A comparison cohort of 84,996 participants was formed by age-, gender-, income-, and urbanization-matched controls.

Interventions: None.

Measurements and results: The two cohorts were followed up for occurrence of autoimmune diseases, including rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), and systemic sclerosis (SSc). A Cox proportional hazards regression model was used for muti-variate adjustment. In patients with NSD, the overall risk for incident autoimmune diseases was significantly higher than in controls (adjusted hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.41-1.53). With regard to individual diseases, the risks for SLE, RA, AS and SS among NSD patients were also significantly higher than in controls (HR [95% CI] for SLE, RA, AS, and SS were 1.81 [1.50-2.18], 1.45 [1.36-1.54], 1.53 [1.38-1.70], and 1.51 [1.43-1.60], respectively), whereas the increased risk for SSc did not reach statistical significance (HR: 1.36 [0.82-2.26]).

Conclusion: Patients with non-apnea sleep disorder were associated with a higher risk for developing autoimmune diseases.

Keywords: autoimmune disease; autoimmunity; non-apnea sleep disorder; sleep disorder.

MeSH terms

  • Arthritis, Rheumatoid / epidemiology
  • Autoimmune Diseases / epidemiology*
  • Cohort Studies
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Income / statistics & numerical data
  • Lupus Erythematosus, Systemic / epidemiology
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Scleroderma, Systemic / epidemiology
  • Sjogren's Syndrome / epidemiology
  • Sleep Apnea Syndromes
  • Sleep Wake Disorders / epidemiology*
  • Spondylitis, Ankylosing / epidemiology
  • Taiwan / epidemiology
  • Urban Population / statistics & numerical data