Obstructive sleep apnea in sarcoidosis and impact of cpap treatment on fatigue

Pier-Valerio Mari, Giuliana Pasciuto, Matteo Siciliano, Jacopo Simonetti, Federico Ballacci, Francesco Macagno, Bruno Iovene, Filippo Martone, Giuseppe Maria Corbo, Luca Richeldi

Research output: Contribution to journalArticle


Rationale: An increased incidence of Obstructive Sleep Apnea (OSA) in sarcoidosis has been described in small sample size studies. Fatigue is common in sarcoidosis and OSA could be a relevant, treatable comorbidity. To date, the effect of Continuous Positive Airway Pressure (CPAP) on fatigue has never been assessed. Objectives: To investigate the prevalence of OSA in sarcoidosis, fatigue status and daytime sleepiness in patients of our center. To explore the effect of CPAP in fatigue and daytime sleepiness after 3 months using validated questionnaires. Method: Single group, one center, open-label prospective cohort study. Measurements and main result: We enrolled 68 patients and OSA was diagnosed in 60 (88.2%): 25 (36.8%) were mild while 35 (51.5%) were moderate-to-severe. 38 (55.9%) patients received CPAP but only 20 (30.9%) were compliant at 3-month evaluation. Questionnaires demonstrated fatigue in 34 (50%) and daytime sleepiness in 21 (30.9%). In multivariate regression analysis, Scadding stage and FAS behave as predictors of Apnea-Hypopnea Index (AHI) severity while sleepiness and steroids weren't associated. FAS score (ΔFAS = 6.3; p = 0.001) and ESS score (ΔESS = 2.8; p = 0.005) improved after three months of CPAP. Conclusions: OSA is highly prevalent in patients affected by sarcoidosis. ESS questionnaire is not reliable for OSA screening and other pre-test probability tool should be evaluated in further studies. CPAP leads to a significative reduction of fatigue and daytime sleepiness at three-month. Further studies are needed to confirm the high prevalence of OSA in sarcoidosis and the positive role of CPAP in fatigue. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (2): 169-178).
Original languageEnglish
Pages (from-to)169-178
Number of pages10
JournalSarcoidosis Vasculitis and Diffuse Lung Diseases
Publication statusPublished - 2020


  • Aged
  • CPAP
  • Continuous Positive Airway Pressure
  • Fatigue
  • Female
  • Humans
  • Lung
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Recovery of Function
  • Respiration
  • Risk Factors
  • Rome
  • Sarcoidosis
  • Sleep
  • Sleep Apnea
  • Sleep Apnea, Obstructive
  • Sleep Wake Disorders
  • Time Factors
  • Treatment Outcome


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