Altered irisin/BDNF axis parallels excessive daytime sleepiness in obstructive sleep apnea patients

Abstract

Study objectives Obstructive sleep apnea hypopnea syndrome (OSAHS) is a sleep-related breathing disorder, characterized by excessive daytime sleepiness (EDS), paralleled by intermittent collapse of the upper airway. EDS may be the symptom of OSAHS per se but may also be due to the alteration of central circadian regulation. Irisin is a putative myokine and has been shown to induce BDNF expression in several sites of the brain. BDNF is a key factor regulating photic entrainment and consequent circadian alignment and adaptation to the environment. Therefore, we hypothesized that EDS accompanying OSAHS is reflected by alteration of irisin/BDNF axis. Methods Case history, routine laboratory parameters, serum irisin and BDNF levels, polysomnographic measures and Epworth Sleepiness Scale questionnaire (ESS) were performed in a cohort of OSAHS patients ( n = 69). Simple and then multiple linear regression was used to evaluate data. Results We found that EDS reflected by the ESS is associated with higher serum irisin and BDNF levels; β: 1.53; CI: 0.35, 6.15; p = 0.012 and β: 0.014; CI: 0.0.005, 0.023; p = 0.02, respectively. Furthermore, influence of irisin and BDNF was significant even if the model accounted for their interaction ( p = 0.006 for the terms serum irisin, serum BDNF and their interaction). Furthermore, a concentration-dependent effect of both serum irisin and BDNF was evidenced with respect to their influence on the ESS. Conclusions These results suggest that the irisin-BDNF axis influences subjective daytime sleepiness in OSAS patients reflected by the ESS. These results further imply the possible disruption of the circadian regulation in OSAHS. Future interventional studies are needed to confirm this observation.

BDNF and proBDNF Serum Protein Levels in Obstructive Sleep Apnea Patients and Their Involvement in Insomnia and Depression Symptoms

“…Moreover, the level of both proteins was positively correlated with total sleep time (TST). Even though the effect sizes of these differences in our studies were low, they were in line with Kaminska et al and More et al, who showed a similar association between daytime sleepiness and BDNF overexpression in OSA [ 32 , 70 ]. In these studies, daytime sleepiness was evaluated by ESS.…”

Irisin Is Correlated with Blood Pressure in Obstructive Sleep Apnea Patients

“…Then, it should be noticed that altered irisin/BDNF axis may be causative for circadian misalignment in OSA, and thus it might be suggested that excessive daytime sleepiness could be a result of the deterioration of circadian rhythm along with changes of serum irisin level [ 14 ]. Significant changes in ESS score, a simple questionnaire for patients' self-assessment of daytime sleepiness, were experienced if serum irisin level changed by 1 ng/mL, given the limited serum level of BDNF [ 26 , 27 ].…”

“…A 10% weight gain gives rise to a 32% increase in the AHI; a 10% reduction yields a 26% improvement in OSA severity [ 13 ]. In addition, some investigators suppose that altered irisin/BDNF axis may be causative for circadian misalignment which leads to the excessive daytime sleepiness in OSA [ 14 ]. Moreover, notably some studies have also shown that serum irisin concentrations are still closely linked with the prevalence of OSA after getting rid of obesity interference by adjusting for BMI [ 15 ].…”

Adipomyobiology Of Obesity And Related Diseases: Therapy Insights

“…Whereas elevated circulating irisin level was suggested to have role in the development of insuline resistance and atherosclerosis in patients with obstructive sleep apnea (32). Altogether, these data collectively suggest that diabetes and related CMD might, at least in part, be viewed as irisin-mediated disorders (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42).…”