In my book Sleep, Interrupted, which was published in 2008, I commented on the association between sleep-related breathing disorders and autoimmune conditions. This was based on a revelation I had after reading Dr. Robert Sapolski’s book, Why Zebras Don’t Get Ulcers. He hypothesized that chronic stress due to any reason, can stimulate your immune and nervous systems to stay overly active all the time. Having breathing pauses 20 to 50 times every hour can be considered a chronic low-grade stress response.
In this month’s issue of the journal SLEEP, researchers from Taiwan looked at over 100,000 people with obstructive sleep apnea diagnoses from 2002 to 2011. The rates of various autoimmune disorders were found to be significantly higher in people with obstructive sleep apnea, compared to matched controls. Specifically, rheumatoid arthritis had 1.33 x, Sjogren’s disease 3.45 x, and Behçet’s disease 5.33 x higher rate of what’s called the hazzard ratio, compared to controls. A hazard ratio is a measure of how often a particular event happens in one group compared to how often it happens in another group, over time. Interestingly, people who were treated for sleep apnea had about a 50% lower rate of rheumatoid arthritis and other autoimmune conditions.
Like with all retrospective scientific research studies, association does not imply causation. So far, I am not aware of any published prospective studies looking at this issue.
I made another few predictions in my book: the potential link between obstructive sleep apnea and cancer and skin disorders such as psoriasis. I’ll expand on these topics in later posts.
Over the years, I’ve had numerous patients tell me that their rheumatoid arthritis got significantly better after starting CPAP. Do you have any autoimmune conditions that got better after treating for sleep apnea? Please tell us your story in the comments area below.