We report a case of a patient with restrictive lung disease secondary to a body mass index of 36.54 kg/m<sup>2</sup>, obstructive sleep apnea, and psoriasis, who developed IP and ARDS presumed to be secondary to guselkumab, an anti-IL-23p19 subunit monoclonal antibody. The gene discussed is IL23A; the disease is obstructive sleep apnea syndrome.