Polycystic Ovary Syndrome Is Associated With Obstructive Sleep Apnea and Daytime Sleepiness: Role of Insulin Resistance

Vgontzas, Alexandros N.; Legro, Richard S.; Bixler, Edward O.; Grayev, Allison; Kales, Anthony; Chrousos, George P.

doi:10.1097/00006254-200107000-00017

Cited by 98 publications

(213 citation statements)

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“…Moreover, there was a statistically significant relationship between waist:hip ratio and AHI in PCOS patients. The same year Vgontzas et al reported an odds ratio (OR) for OSA in PCOS was 30.6 [12]. Similar findings were reported by Gopal et al-69.6% of their patients had OSA diagnosed by polysomnography (PSG) and obesity was not shown to correlate with its presence [13].…”

Section: Discussionsupporting

confidence: 56%

“…Another possibility may be that the actual prevalence of OSA in PCOS may not be very high. In the study by Vgontzas et al, the actual prevalence of OSA as defined by PSG, while significantly greater than the controls, was only 17% [12].…”

Section: Discussionmentioning

confidence: 83%

“…Several studies have recently demonstrated a close link between PCOS and OSA [11][12][13][14]. Fogel el al.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have documented an important link between PCOS and OSA [11][12][13][14]. In the study by Vgontzas et al, the odds ratio for OSA in PCOS patients was 30.6 [12].…”

Section: Introductionmentioning

confidence: 97%

“…In the study by Vgontzas et al, the odds ratio for OSA in PCOS patients was 30.6 [12]. In a recent review article on PCOS, Ehrmann et al recommended risk assessment for OSA in all patients with PCOS and a polysomnogram for those deemed to be at-risk [13].…”

Section: Introductionmentioning

confidence: 99%

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Practice patterns of screening for sleep apnea in physicians treating PCOS patients

et al. 2007

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Women with polycystic ovarian syndrome (PCOS) have been shown to have a very high prevalence of obstructive sleep apnea (OSA). Screening for OSA is recommended for PCOS patients. How far this is carried out in actual practice is unknown. To study practice patterns with regard to screening for OSA in physicians-both obstetrician/gynecologists (ObGyn) and endocrinologist-who manage PCOS. A secondary aim of this study was to identify practice differences, if any. Two hundred ObGyn and 140 endocrine academic institutions were contacted and mailed with questionnaires, if willing to participate. Responses were obtained from 50 (29.4%) ObGyn physicians and 29 (26.4%) endocrine physicians. The questionnaire was closed-ended. Physicians reported a high occurrence of obesity-36.7% of the physicians reported that 75-100% of their patients had morbid obesity. However, reported prevalence of symptoms was low-86.1% of the physicians felt their patients snored infrequently (<25% of the time) and 74.7% felt that their patients had excess daytime sleepiness (EDS) infrequently. Of the physicians, 92.4% ordered a sleep study <25% of the time. No significant difference in practice between the specialties was identified. Physicians who manage PCOS patients do not believe that these patients have significant symptoms nor warrant frequent testing for OSA. This may reflect lack of knowledge about the link or may imply that PCOS patients remain largely asymptomatic. Educating specialist physicians managing PCOS about OSA and improved tools for OSA screening may improve detection.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 83%

“…Several studies have recently demonstrated a close link between PCOS and OSA [11][12][13][14]. Fogel el al.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have documented an important link between PCOS and OSA [11][12][13][14]. In the study by Vgontzas et al, the odds ratio for OSA in PCOS patients was 30.6 [12].…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Practice patterns of screening for sleep apnea in physicians treating PCOS patients

et al. 2007

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Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Jacewicz-Święcka

Kowalska

2018

Diabetes Metabolism Res

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The purpose of this study was to perform a review of the longitudinal studies to determine whether polycystic ovary syndrome is associated with higher prevalence of metabolic complications and cardiovascular morbidity and mortality. The primary outcomes included body mass index, metabolic syndrome and its components (waist circumference, lipid profile, arterial hypertension, abnormal glucose metabolism (impaired fasting glucose, impaired glucose tolerance, type 2 diabetes), insulin resistance, and cardiovascular diseases like stroke, angina, and coronary heart disease. Complications in pregnant women were beyond the scope of this review. PubMed database (1992-2018) was searched to identify proper publications. Finally, data from 47 articles were analysed. Studies differed in the design (prospective, retrospective, cohort, observational), research methods, polycystic ovary syndrome diagnostic criteria, studied populations, race, and ethnicity of the participants. Based on the data collected, it appears that women with polycystic ovary syndrome have higher prevalence of obesity, abdominal fat distribution, dyslipidaemia and deterioration of glucose metabolism, but increased prevalence of cardiovascular diseases is not proven.

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Novel retrospective, respiratory‐gating method enables 3D, high resolution, dynamic imaging of the upper airway during tidal breathing

Wagshul

Sin

Lipton

et al. 2013

Magnetic Resonance in Med

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Purpose To develop a retrospective, respiratory-gated technique for measuring dynamic changes in the upper airway over the respiratory cycle, with the ultimate goal of constructing anatomically and functionally accurate upper airway models in obstructive sleep apnea (OSA) patients. Methods 3D cine, retrospective respiratory-gated, gradient echo imaging was performed in six adolescents being evaluated for polycystic ovary syndrome, a disorder with a high OSA prevalence. A novel retrospective gating scheme, synchronized to flow from a nasal cannula, limited image acquisition to pre-defined physiological ranges. Images were evaluated with respect to contrast, airway signal leakage, and demonstration of dynamic airway area changes. Results Two patients were diagnosed with obstructive sleep apnea. Scan efficiency ranged from 48–88%. Soft tissue-to-airway contrast-to-noise ratio varied from 6.1–9.6. Airway signal leakage varied between 10–17% of soft tissue signal. Motion artifacts were absent in all image sets. Automated segmentation allowed calculation of airway area changes over the respiratory cycle. In one severe apnea patient, the technique allowed demonstration of asynchronous airway expansion and contraction above and below a severe constriction. Conclusions Retrospective, respiratory gated imaging of the upper airway has been demonstrated, utilizing a gating algorithm to ensure acquisition over specified ranges of respiratory rate and tidal volume.

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Polycystic Ovary Syndrome Is Associated With Obstructive Sleep Apnea and Daytime Sleepiness: Role of Insulin Resistance

Cited by 98 publications

References 0 publications

Practice patterns of screening for sleep apnea in physicians treating PCOS patients

Practice patterns of screening for sleep apnea in physicians treating PCOS patients

Polycystic ovary syndrome and the risk of cardiometabolic complications in longitudinal studies

Novel retrospective, respiratory‐gating method enables 3D, high resolution, dynamic imaging of the upper airway during tidal breathing

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