Chronic toxoplasmosis and sleepiness in obstructive sleep apnea: Is there a link?

Abstract

Introduction Sleepiness is the main clinical expression of obstructive sleep apnea (OSA) syndrome resulting from upper airway collapse. Recent studies have discussed the fact that the presence of T. gondii cysts in the brain and the resulting biochemical and immunological mechanisms could be linked to neurobehavioral disorders. The aim of the present study was to explore the potential impact of chronic toxoplasmosis on sleepiness and on obstructive sleep apnea (OSA) severity in OSA obese patients. Materials and methods A case control study on obese patients screened for OSA was performed. According to the sleep disorder and matched based on gender, age and body mass index (BMI), two groups of obese patients were selected from our sample collection database. All patients were tested for toxoplasmosis serological status measuring anti-Toxoplasma IgG and IgM levels. Univariable and multivariable logistic regression models were performed to assess the impact of chronic toxoplasmosis on sleepiness and OSA severity. Results 107 obese patients suffering from OSA were included in the study (median age: 53.3 years Interquartile range (IQR): [41.9-59.9]; median BMI: 39.4 kg/m 2 IQR: [35.5-44.1], apneahypopnea index = 27.5 events/h [10.7-49.9]). Chronic toxoplasmosis was present in 63.4% and 70.7% of patients with or without sleepiness (p = 0.48), respectively and was not associated either to sleepiness (OR: 0.76, 95% CI: [0.52; 2.33], p = 0.64) or OSA severity (OR = 1.75, 95% CI: [0.51; 5.98] p = 0.37). Conclusion Although chronic Toxoplasma infection in immunocompetent humans has been associated to several behavioral disorders or pathologies in recent literature, we demonstrate here that

Neurological and Neurobehavioral Disorders Associated with Toxoplasma gondii Infection in Humans

“…In a study performed by Ahmad et al attempting to link T. gondii infection and sleep disturbance, such as quality or quantity of sleep, no linkage was found [ 151 ]. There also was no association found between T. gondii and sleepiness or sleep apnea in obese patients [ 152 ]. Indeed, in a study conducted by Corona et al, T. gondii seropositivity was linked to less sleep problems [ 153 ].…”

Chronic Toxoplasma gondii infection and sleep‐wake alterations in mice

“…We are not aware of similar experiments. The few previous studies addressing the question in patients were limited by the use of indirect outcomes such as sleep apnea or daytime sleepiness, 34 or sleep self‐report, 35 and by the need to rely on a single anti‐ Tg IgG test to recognize infected subjects, precluding any estimation regarding time elapsed since infection.…”