Sleep apnoea, sleepiness, inflammation and insulin resistance in middle-aged males and females

Abstract

In obese males obstructive sleep apnoea (OSA) is associated with inflammation and insulin resistance; however, findings are confounded by adipose tissue, a hormone-and cytokine-secreting organ. Our goal was to examine whether in a relatively nonobese population, OSA is associated with sleepiness and inflammation/insulin resistance, and to assess the effects of a 2-month placebo-controlled continuous positive airway pressure (CPAP) use.77 subjects, 38 middle-aged males and post-menopausal females with OSA and 39 male and female controls, were studied in the sleep laboratory for 4 nights. Measures of sleepiness (objective and subjective), performance, serial 24-h blood samples for interleukin (IL)-6, tumour necrosis factor receptor (TNFR)-1, leptin and adiponectin, and single samples for high-sensitivity C-reactive protein (hsCRP), fasting glucose and insulin levels were obtained.Apnoeic males were significantly sleepier and had significantly higher hsCRP, IL-6, leptin and insulin resistance than controls. Apnoeic females had significantly higher hsCRP; however, objective sleepiness, IL-6, TNFR-1, insulin resistance (Homeostatic Model Assessment index), leptin and adiponectin were similar to controls. CPAP improved subjective sleepiness, but no changes were observed in any of the biomarkers.In conclusion, OSA is associated with sleepiness, inflammation and insulin resistance, even in nonobese males, and this association is stronger in males than in females. Short-term CPAP does not improve the inflammatory/metabolic aberrations in OSA. @ERSpublications OSA is associated with sleepiness and inflammation/insulin resistance in nonobese males and females

Sleep apnoea and the hypothalamic–pituitary–adrenal axis in men and women: effects of continuous positive airway pressure

“…Finally, patients with apnoea had significantly higher BDI-II scores, but their BAI scores were not significantly different. Similarly to what we have previously reported [18,19], apnoeic women had significantly higher BDI-II scores than their controls, while no differences in BDI-II or BAI scores between apnoeic and control men were observed. However, it should be noted that due to our inclusion criteria, BDI-II scores were very low, and thus not indicative of clinical depression for both apnoeics and controls.…”

“…A thorough medical assessment, including history, physical examination, routine laboratory tests and sleep history, was completed for each participant as described in more detail above [18,19]. Anthropometric parameters were obtained and BMI was calculated based on height and weight measured as part of the physical examination.…”

“…Anthropometric parameters were obtained and BMI was calculated based on height and weight measured as part of the physical examination. All potential participants were screened in the sleep laboratory for one night for 8 h; subjects who met the inclusion criteria were then monitored in the sleep laboratory for four consecutive nights (one adaptation and three baseline nights) [18,19]. For the sleep monitoring, all of the subjects slept in a sound-attenuated, temperature-and light-controlled room in our sleep laboratory.…”

“…Despite our efforts, our sample of women consisted of slightly obese patients because 1) in central Pennsylvania women are heavier compared with national standards and 2) women with OSA are heavier than men, both in clinical and epidemiological samples [18,19]. A secondary goal was to assess the effect of a placebo-controlled (sham-CPAP) 2-month CPAP trial on the circadian cortisol secretory profile.…”

Effect of Continuous Positive Airway Pressure on Adiponectin in Patients With Obstructive Sleep Apnea: A Meta-analysis

“…One of them was randomized clinical trial (RCT) [19], the remaining studies were observational [20][21][22][23][24][25][26][27][28][29]. One study [27] reported results separately for obese group and non-obese group.…”