title: Excessive daytime sleepiness and obstructive sleep apnea in patients with sarcoidosis.
abstract: 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.
authors.affiliation: Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL. Electronic address: karen.patterson@uphs.upenn.edu.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Patterson
authors.affiliation: Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL.
authors.forename: Frank
authors.initials: F
authors.lastname: Huang
authors.affiliation: Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Oldham
authors.affiliation: Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL.
authors.forename: Nakul
authors.initials: N
authors.lastname: Bhardwaj
authors.affiliation: Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL.
authors.forename: D Kyle
authors.initials: DK
authors.lastname: Hogarth
authors.affiliation: Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL; University of Chicago Sleep Disorders Center, The University of Chicago, Chicago, IL.
authors.forename: Babak
authors.initials: B
authors.lastname: Mokhlesi
mesh_terms: D016009:Chi-Square Distribution; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011788:Quality of Life; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires