Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women

Ljunggren, Mirjam; Lindberg, Eva; Franklin, Karl A.; Öhagen, Patrik; Larsson, Marita; Theorell‐Haglöw, Jenny; Naessén, Tord

doi:10.1093/sleep/zsy099

Cited by 32 publications

(37 citation statements)

References 38 publications

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“…Some data also indicate that OSA during rapid eye movement (REM) sleep is more important than nonrapid eye movement when it comes to diabetes risk [13]. Furthermore, REM-AHI is also associated with elevated sympathetic activity and adverse cardiovascular events in patients with OSA [14,15].…”

Section: Introductionmentioning

confidence: 99%

Sleep apnea in men is associated with altered lipid metabolism, glucose tolerance, insulin sensitivity, and body fat percentage

et al. 2020

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Purpose Obstructive sleep apnea (OSA) is associated with obesity and risk for type 2 diabetes. In this community-based study, we thoroughly investigated fatty acid metabolism, incretin response, glucose tolerance, insulin secretion and insulin sensitivity, and autonomic nerve activity in men with or without OSA. Methods Fifteen men without diabetes but with signs of severe OSA, defined as apnea–hypopnea index (AHI) >30, and 15 age- and BMI-matched men without OSA (AHI < 5) were recruited from a community-based cohort. Assessments included clinical and anthropometric measurements, a 2-h oral glucose tolerance test (OGTT), and autonomic nerve activity using heart rate variability (HRV). Results Men with OSA had higher body fat % than BMI-matched men without OSA (p = 0.046) and it was associated with markers of insulin resistance. The area under the curve for nonesterified fatty acids (NEFA) during OGTT was higher in men with OSA (p = 0.021) and fasting NEFA levels were numerically higher (p = 0.097). The plasma glucose at fasting and during OGTT was higher in men with OSA (p < 0.001). Incretin response was similar between groups. Fasting and OGTT-derived indices indicated impaired insulin sensitivity in men with OSA. Compared with men without OSA, Matsuda index (p = 0.068) and Gutt index (p < 0.01) were lower in men with OSA. The HRV measures did not differ between groups. Conclusions Our study suggests that fatty acid handling, glucose tolerance, and insulin sensitivity are impaired in men with severe OSA. This might partly be explained by the increased body fat percentage.

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Section: Introductionmentioning

confidence: 99%

Sleep apnea in men is associated with altered lipid metabolism, glucose tolerance, insulin sensitivity, and body fat percentage

et al. 2020

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“…Very few studies have investigated the association between psoriasis and OSAS. Studies have shown a relation between OSAS and metabolic syndrome, atherosclerotic diseases (10,11). The risk of metabolic syndrome and atherosclerotic diseases is also higher in psoriasis patients, and due to the close association between these conditions and OSAS.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients

Karagün

Balbay

2019

Düzce Tıp Fakültesi Dergisi

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Aim: Psoriasis is a frequently seen chronic systemic inflammatory disease accompanied by several comorbid conditions that affects 2-3% of the general population. One of the comorbidities rarely accompanying psoriasis is obstructive sleep apnea syndrome (OSAS). OSAS is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper airway obstruction episodes and frequently by decreased blood oxygen saturation. The purpose of this study was to evaluate the risk factors for OSAS by investigating OSAS symptoms in psoriasis patients. Material and Methods: Eighty-two patients aged over 16, diagnosed with psoriasis, and under follow-up by the Duzce University Medical of Faculty, Dermatology and Venereal Diseases Polyclinic, Turkey, were included in the study. Patients' OSAS symptoms were investigated. The Epworth Sleepiness Scale was used to assess excessive daytime somnolence. Results: Of the patients 51.2% (n=42) were male and 48.8% (n=40) female. Patients' mean age was 47.09±14.10 years. Patients' mean time of psoriasis diagnosis was 16.97±10.55 years, and mean Psoriatic Area Severity Index (PASI) score was 11.25±6.32. Severe disease was present in 54.9% of patients (n=45) based on PASI classification. Prevalence of 56.1% for snoring, 25.6% for excessive daytime sleepiness, and 15.9% for witnessed apnea were determined in these patients. Forty-seven (57.3%) cases had at least one major symptom. The most common minor symptoms were inability to sleep with 25.6% (n=21) and insufficient disrupted sleep with 22.0% (n=18). Conclusion: Prevalence of OSAS symptoms in psoriasis patients were found high. Psoriasis patients with OSAS symptoms must be referred to relevant specialists for polysomnographic evaluation.

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“…A possible explanation is gonadal hormones, such as progesterone, may play an important role in increasing upper-airway muscle tone during wakefulness and NREM sleep, but this protective effect disappears during REM sleep [11]. In the community based "Sleep and Health in Women" cohort study, repeated obstructive apnea during REM sleep was considered to be a cerebrovascular risk, defined as increased carotid artery intima thickness, at 10-year follow-up [40]. This implies that the presence of frequent obstructive apnea during REM sleep might be considered in early diagnosis and continuous positive airway pressure treatment of OSA.…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Korean Patients with Obstructive Sleep Apnea

Pyun

Choi

et al. 2020

Sleep Med Res

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Background and ObjectiveaaOur objective in this study was to investigate gender-specific differences in demographic factors, clinical presenting symptoms, medical comorbidities, and sleeprelated parameters in patients newly diagnosed with obstructive sleep apnea (OSA). MethodsaaWe enrolled patients who were more than 30 years old, had undergone overnight polysomnography, and had filled out the questionnaires, including demographics, medical comorbidities, and sleep-related symptoms. ResultsaaFrom December 2014 to August 2017, 1224 patients (female, n = 277, 22.6%) were newly diagnosed with OSA. Female patients were significantly older than males (59.62 years vs. 52.75 years, p < 0.001). Alcohol consumption and current smoking were more common in males (p < 0.001). Non-specific symptoms of OSA, such as insomnia-related symptoms, loss of energy, and subjective poor sleep, were observed more frequently in females. Females reported more depressive moods (Beck Depression Inventory-II 15.58) than males did (12.17). Males complained about OSA-specific symptoms, such as snoring, witnessed apnea, and daytime sleepiness, more frequently than females did. The mean apnea-hypopnea index (AHI) was much lower in females (26.25 /h vs. 33.36 /h), but AHI during rapid eye movement sleep was similar for the two groups (33.55 /h vs. 32.76 /h). Sleep latency was longer (15.45 min vs. 10.11 min) and spontaneous arousal index (4.48 /h vs. 3.48 /h) was more frequent in females. ConclusionsaaFemales have a different OSA phenotype from males in terms of demographics, clinical manifestations, and sleep parameters of polysomnography. Thus, clinicians should comprehend the different clinical phenotype of female OSA and detect earlier unrecognized OSA in females.

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Obstructive sleep apnea during rapid eye movement sleep is associated with early signs of atherosclerosis in women

Abstract: In this study of a community-based sample of women, severe OSA during REM sleep was independently associated with early signs of atherosclerosis.

Cited by 32 publications

References 38 publications

Sleep apnea in men is associated with altered lipid metabolism, glucose tolerance, insulin sensitivity, and body fat percentage

Sleep apnea in men is associated with altered lipid metabolism, glucose tolerance, insulin sensitivity, and body fat percentage

Prevalence of Obstructive Sleep Apnea Syndrome in Psoriasis Patients

Gender Differences in Korean Patients with Obstructive Sleep Apnea

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