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Original Research: Sleep Disorders |

Excessive Daytime Sleepiness and Obstructive Sleep Apnea in Patients With SarcoidosisSleepiness in Sarcoidosis

Karen C. Patterson, MD; Frank Huang, MD; Justin M. Oldham, MD; Nakul Bhardwaj, BS; D. Kyle Hogarth, MD, FCCP; Babak Mokhlesi, MD, FCCP
Author and Funding Information

From the Section of Pulmonary and Critical Care (Drs Patterson, Huang, Oldham, Hogarth, and Mokhlesi and Mr Bhardwaj), and The University of Chicago Sleep Disorders Center (Dr Mokhlesi), The University of Chicago, Chicago, IL.

Correspondence to: Karen C. Patterson, MD, Pulmonary, Allergy, & Critical Care Division, University of Pennsylvania, 824 W Gates, 3600 Spruce St, Philadelphia, PA 19104; e-mail: karen.patterson@uphs.upenn.edu


Dr Patterson is currently at the University of Pennsylvania (Philadelphia, PA).

Funding/Support: The authors have reported to CHEST that no funding was received for this study.

For editorial comment see page 1523

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(6):1562-1568. doi:10.1378/chest.12-1524
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Background:  Systemic symptoms are common in sarcoidosis and are associated with a decreased quality of life. Excessive daytime sleepiness (EDS) often is associated with obstructive sleep apnea (OSA) but may be a systemic symptom independently associated with sarcoidosis. The aim of this study was to assess the relationship between sarcoidosis and EDS.

Methods:  In a retrospective analysis, we used Epworth Sleepiness Scale scores to compare sleepiness in 62 patients with sarcoidosis with 1,005 adults without sarcoidosis referred for polysomnography for suspicion of OSA. Linear regression models controlled for covariates. In a subgroup analysis of patients with sarcoidosis, sleepiness scores and polysomnograms were compared between those with normal and those with abnormal pulmonary function based on total lung capacity.

Results:  EDS was more common in patients with sarcoidosis than in those without, and sarcoidosis remained an independent predictor of increased sleepiness after controlling for covariates. Compared with control patients referred for polysomnography, fewer patients with sarcoidosis had clinically significant OSA. However, among patients with sarcoidosis, OSA was more severe in those with abnormal lung function.

Conclusions:  Sarcoidosis is independently associated with EDS. Sleepiness may contribute to the morbidity of sarcoidosis and should be followed even after treating for potentially coexisting OSA or depression. Abnormal lung function in sarcoidosis may contribute to OSA, although the mechanisms for this are not known.

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