Prevalence and impact of sleep disorders in patients with hereditary angioedema: A multicenter cross-sectional study in Latin America

Abstract Background Hereditary angioedema (HAE) is a rare disease characterized by recurrent swelling episodes that may affect sleep and quality of life. Because data on sleep disorders in Latin American patients with HAE are limited, we assessed their prevalence and clinical correlates using structured sleep and HAE patient-reported outcome measures. Objective To assess the prevalence/impact of sleep disorders in HAE patients using validated tools. Methods This cross-sectional, multicenter online survey included adult patients (> = 18 years) with clinician-confirmed HAE from 13 reference centers in five Latin American countries. Data were collected between August and December 2023. Sleep was assessed using the Global Sleep Assessment Questionnaire (GSAQ), SATED scale, and STOP-Bang; HAE was assessed using the Hereditary Angioedema Activity Score (HAE-AS), Angioedema Control Test (AECT), and Angioedema Quality of Life questionnaire (AE-QoL). Logistic regression models were adjusted for age, sex, and BMI. Results The final analytic sample included 139 participants. Most patients had HAE-C1INH type 1 (64.0%) and were female (68.4%). Only 6.5% had good sleep health, and the mean SATED score was 5.46 (1.87). Insomnia was reported by 54.0% of participants, and 34.5% had STOP-Bang moderate-to-high OSA risk. In age-, sex-, and BMI-adjusted models, severe HAE activity was associated with higher odds of insomnia (OR = 2.62, 95% CI: 1.28–5.35, P = 0.008), RLS/PLMD (OR = 5.85, 95% CI: 1.59–21.62, P = 0.008), and STOP-Bang moderate-to-high OSA risk (OR = 2.37, 95% CI: 1.01–5.55, P = 0.047). Higher AE-QoL fatigue/mood and fears/shame scores were associated with several sleep outcomes. AECT control status did not show a consistent independent association after simultaneous adjustment. Conclusion In this exploratory cross-sectional study, HAE activity and quality-of-life impairment were associated with several sleep outcomes. Targeted sleep screening may be useful in HAE care pathways if these associations are confirmed in prospective studies.