uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
The role of obstructive sleep apnea in metabolic syndrome: A population-based study in women
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Internal Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
2011 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 12, no 4, 329-334 p.Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to assess associations between obstructive sleep apnea (USA) and metabolic syndrome in a population-based sample of women.

Methods: Four hundred women aged 20-70 years underwent a full-night polysomnography, fasting blood sampling and measurement of anthropometric variables. Metabolic syndrome was defined according to the National Cholesterol Education Program (NCEP) criteria.

Results: The NCEP criteria of metabolic syndrome were fulfilled by 104 (26.0%) of the women. The frequency of metabolic syndrome increased from 10.5% in women with apnea-hypopnea-index (AHI) < 5 to 57.1% in women with AHI >= 30 (p for trend < 0.0001). In the multivariate analysis, the severity of USA measured as AHI, ODI (oxygen desaturation index), minimal saturation or T-90 (percentage of time during night with saturation < 90%) were associated with metabolic syndrome after adjustment for age, level of physical activity, smoking and alcohol consumption. AHI (adj. OR 1.45; 95% CI 1.11-1.91), ODI (1.37; 1.09-1.73) and minimal saturation level (0.93; 0.87-0.99) remained significantly associated with metabolic syndrome also when adjusting for the waist-to-hip-ratio. The three markers of USA were independently associated with central obesity, hypertriglyceridemia and reduced HDL cholesterol concentration.

Conclusion: Measures of USA were closely associated with metabolic syndrome and its components in this population-based sample of women also after adjustments. Therefore, when the health consequences of sleep-disordered breathing are investigated it is important to consider metabolic syndrome. Sleep-disordered breathing should also be considered when treating patients with metabolic syndrome.

Place, publisher, year, edition, pages
2011. Vol. 12, no 4, 329-334 p.
Keyword [en]
Obstructive sleep apnea, metabolic syndrome, women, population-based
National Category
Respiratory Medicine and Allergy
Research subject
Lung Medicine
Identifiers
URN: urn:nbn:se:uu:diva-99078DOI: 10.1016/j.sleep.2010.06.014ISI: 000290080400004PubMedID: 21345723OAI: oai:DiVA.org:uu-99078DiVA: diva2:202083
Available from: 2009-03-06 Created: 2009-03-06 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Sleep and Sleep-disordered Breathing in Women: Associations with Daytime Symptoms and Metabolism
Open this publication in new window or tab >>Sleep and Sleep-disordered Breathing in Women: Associations with Daytime Symptoms and Metabolism
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Obstructive sleep apnea (OSA) is characterized by snoring, apneas and excessive daytime sleepiness (EDS). Although commonly present in OSA, factors relating to daytime sleepiness are not fully elucidated. OSA is associated with obesity and with cardiovascular disease, type 2 diabetes mellitus and the metabolic syndrome.

In this population-based study 7,051 women answered a questionnaire on sleep and health. Psychological distress, insomnia and somatic disease were the factors most strongly related to both EDS and fatigue independent of other factors. Snoring was independently associated with both EDS and fatigue, but the associations were relatively weak.

In addition, 400 of the women underwent polysomnography and an oral glucose tolerance test. OSA was associated with changes in glucose metabolism independently of confounders such as central obesity. Moreover, low minimal saturation was independently associated with reduced insulin sensitivity.

In women sleeping <6-7 hours there was a substantial increase in waist circumference and short sleep duration remained associated with central obesity, even after adjusting for body mass index (BMI). The most pronounced negative influence of short sleep duration and also reduced duration of slow-wave sleep (SWS) or rapid eye movement (REM) sleep was seen in women <50 years.

All measures of OSA were related to the metabolic syndrome after adjustments. In addition, the relationship remained after adjusting for central or general obesity. Hypoxia was independently associated with hypertriglyceridemia, even after adjusting for BMI.

In conclusion, OSA may have significant impact on insulin sensitivity and metabolism in women, and the relationship could, to some extent, be mediated through hypoxia. Moreover, reduced sleep duration and loss of SWS and REM sleep may influence central obesity; a strong risk factor for OSA. Daytime sleepiness was most strongly related to psychological distress, insomnia and somatic disease although snoring was also a risk factor. This finding indicates that sleep apnea is only one factor contributing to daytime sleepiness in women.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 73 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 438
Identifiers
urn:nbn:se:uu:diva-99080 (URN)978-91-554-7467-6 (ISBN)
Public defence
2009-04-24, Enghoff-salen, Akademiska sjukhuset, Ing 50, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2009-04-03 Created: 2009-03-06 Last updated: 2009-09-04Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Theorell-Haglöw, JennyBerne, ChristianJanson, ChristerLindberg, Eva

Search in DiVA

By author/editor
Theorell-Haglöw, JennyBerne, ChristianJanson, ChristerLindberg, Eva
By organisation
Respiratory Medicine and AllergologyInternal Medicine
In the same journal
Sleep Medicine
Respiratory Medicine and Allergy

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 459 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf