Interaction between obstructive sleep apnea and short sleep duration on insulin resistance: a large-scale study

Xu, Huajun; Chen, Liang; Zou, Jian; Yi, Hongliang; Guan, Jian; Gu, Ming; Feng, Yanhong; Yin, Shankai

doi:10.1186/s12931-020-01416-x

Cited by 16 publications

(13 citation statements)

References 33 publications

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“…Polysomnographic variables were scored manually by skilled technicians according to the 2012 guidelines of the American Academy of Sleep Medicine (AASM) ( 12 ); if the PSG were recorded before 2012, they were reanalyzed according to the same 2012 AASM criteria. Apnea was defined as at least 90% reduction in airflow for at least 10 s; hypopnea was defined as at least 50% reduction in airflow for at least 10 s or longer and accompanied by at least 3% reduction in oxygen saturation or arousal, as described previously ( 5 ). The AHI was given by the average number of apneas/hypopneas per hour of sleep.…”

Section: Methodsmentioning

confidence: 99%

The Associations Between Sleep Architecture and Metabolic Parameters in Patients With Obstructive Sleep Apnea: A Hospital-Based Cohort Study

Feng

Yang

et al. 2021

Front. Neurol.

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Background and Objectives: The associations between objective sleep architecture and metabolic parameters have been rarely studied in patients with obstructive sleep apnea (OSA). Here, we evaluated the associations between objective sleep measures derived via polysomnography (PSG) and metabolic parameters.Methods: A total of 2,308 subjects with suspected OSA were included. We measured common metabolic parameters such as body mass index (BMI) and glucose, insulin, blood pressure, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels. All subjects underwent full-night PSG. PSG sleep parameters included total sleep time (TST), time spent in slow-wave sleep (SWS) and rapid eye movement (REM) sleep, sleep efficiency, and the microarousal index (MAI).Results: The TST correlated with the BMI, glucose level, and systolic blood pressure. The SWS/TST ratio correlated with BMI and glucose, TC, and TG levels. The REM/TST ratio correlated with BMI, glucose, insulin, and TG levels, and diastolic blood pressure. We found significant relationships between sleep efficiency and BMI, glucose levels, and TG levels. The MAI was significantly correlated with all metabolic parameters. After adjustment for age, gender, smoking status, alcohol use, apnea hypopnea index, and oxygen desaturation index (ODI), multiple linear regression analysis showed that the MAI was independently associated with glucose level, TC, HDL, and LDL. REM/TST ratio was positively associated with diastolic blood pressure but negatively associated with glucose metabolism.Conclusions: Though some independent correlation between sleep and metabolic parameters was confirmed, only weak associations were observed, suggesting a clinically negligible influence of sleep structure. Further prospective studies are warranted to confirm our findings.

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Section: Methodsmentioning

confidence: 99%

The Associations Between Sleep Architecture and Metabolic Parameters in Patients With Obstructive Sleep Apnea: A Hospital-Based Cohort Study

Feng

Yang

et al. 2021

Front. Neurol.

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“…Intermittent hypoxemia activates the sympathetic nervous system. It increases catecholamine levels, decreasing insulin sensitivity and promoting pancreatic beta-cell apoptosis [ 4 ], suggesting a possible mechanism underlying OSA's association with T2DM.…”

Section: Introductionmentioning

confidence: 99%

Association between Obstructive Sleep Apnea and Type 2 Diabetes Mellitus: A Dose-Response Meta-Analysis

Cheng

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Aim/Introduction. Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is characterized by repeated episodes of upper airway occlusion during sleep. The patients with OSA suffered from comprehensive oxidative stress in all systems. OSA might induce type 2 diabetes mellitus (T2DM), a kind of metabolism disorder. In this passage, we are exploring the dose-response relationship between OSA and T2DM. Materials and Methods. We screened four databases (PubMed, Embase, Cochran Library, and CNKI) for the observational studies about the OSA and T2DM. Studies were collected from database establishment to October 2020. We performed a traditional subgroup meta-analysis. What is more, linear and spline dose-response models were applied to assess the association between apnea-hypopnea index (AHI), an indicator to evaluate the severity of OSA, and the risk of T2DM. Review Manager, version 5.3, software and Stata 16.0 were used for the analysis. Result. Seven observational studies were included in the research. We excluded a study in the conventional meta-analysis. In the subgroup analysis, mild-dose AHI increased the risk of T2DM (odds ratio = 1.23, 95% confidence interval = 1.06–1.41, P < 0.05). Moderate-dose AHI increased the risk of T2DM with a higher odds ratio (OR = 1.35, 95% CI = 1.13–1.61, P < 0.05). Moderate-to-severe-dose AHI increased the risk of T2DM with a higher odds ratio (OR = 2.14, 95% CI = 1.72–2.67, P < 0.05). Severe-dose AHI increased the risk of T2DM with a higher odds ratio (OR = 2.19 95% CI = 1.30–3.68, P < 0.05). Furthermore, the spline and linear dose-response meta-analysis results revealed that the risk of T2DM increased with increasing AHI values. Conclusion. Through the dose-response meta-analysis, we found a potential dose-response relationship existed between the severity of OSA and the risk of T2DM. This relationship in our passage should be considered in the prevention of T2DM in the future.

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“…We previously showed that patients with OSA were more likely to exhibit IR when the sleep duration was <5 h ( 41 ). A meta-analysis reported increased CVD mortality at sleep durations ≤ 5 and ≥ 9 h ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

“…The study totally included 4,475 participants, of whom 2,934 were at low risk of CVD and 1,541 at moderate-to-high risk. The median ages of these two groups were 36 (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) and 53 (46-60) years old (P < 0.001). All of the NC, WC, HC, WHR, BMI, SBP, DBP, lipid profiles, fasting glucose and insulin levels were higher in the latter group.…”

Section: Baseline Characteristicsmentioning

confidence: 94%

Associations between common sleep disturbances and cardiovascular risk in patients with obstructive sleep apnea: A large-scale cross-sectional study

Zhang

Huang²,

Xu³

et al. 2022

Front. Cardiovasc. Med.

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ObjectivesStudies have shown that obstructive sleep apnea (OSA) is inextricably linked with cardiovascular diseases (CVD). However, the roles of certain common sleep disturbances, such as low slow-wave sleep, excessive daytime sleepiness and short sleep duration, in the pathogenesis and progression of CVD in patients with OSA have not been determined. Therefore, we conducted a large cross-sectional study to explore the effect of low slow-wave sleep, excessive daytime sleepiness and short sleep duration on the risk of CVD in patients with OSA.MethodsSubjects were consecutively enrolled to participate in the sleep center of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital. All OSA patients were diagnosed by standard polysomnography, while controls were all simple snorers. A total of 4,475 participants were strictly recruited. The Framingham Risk Score were employed to assess the 10-year risk of CVD, and logistic regression was used to measure the association between sleep disturbances and the moderate-to-high CVD risk.ResultsIn the whole cohort, OSA, excessive daytime sleepiness, and low slow-wave sleep were all risk factors for the moderate-to-high 10-year CVD risk (odds ratio [OR] = 3.012, 95% confidence interval [CI] 2.418–3.751; OR = 1.407, 95% CI: 1.228–1.613, and OR = 0.973,95% CI: 0.967–0.980), but sleep duration did not contribute significantly to that risk. Whether in patients with OSA and controls, low SWS (<12.8%) could increase the risk of CVD. Subjective excessive daytime sleepiness would significantly increase the risk of CVD only in patients with severe OSA.ConclusionIt is important to pay more attention to the impact of sleep on cardiovascular health. Patients with sleep disturbances should adopt a healthy lifestyle and undergo regular follow-up of cardiovascular indicators to prevent cardiovascular complications.Trial registration[http://www.chictr.org.cn/showproj.aspx?proj=43057], identifier [ChiCTr1900025714].

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Interaction between obstructive sleep apnea and short sleep duration on insulin resistance: a large-scale study

Cited by 16 publications

References 33 publications

The Associations Between Sleep Architecture and Metabolic Parameters in Patients With Obstructive Sleep Apnea: A Hospital-Based Cohort Study

The Associations Between Sleep Architecture and Metabolic Parameters in Patients With Obstructive Sleep Apnea: A Hospital-Based Cohort Study

Association between Obstructive Sleep Apnea and Type 2 Diabetes Mellitus: A Dose-Response Meta-Analysis

Associations between common sleep disturbances and cardiovascular risk in patients with obstructive sleep apnea: A large-scale cross-sectional study

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