Epidemiology, Risk Factors, and Consequences of Obstructive Sleep Apnea and Short Sleep Duration

The role of obstructive sleep apnea (OSA) in pregnancy is not well studied, but an increasing body of literature appears to indicate that there may be adverse maternal and fetal health effects of the disease. OSA is associated with a twofold risk for pre-eclampsia. The small size of the existing investigations still leave unanswered questions about the consequences of OSA as it relates to some other clinically relevant outcomes such as eclampsia, stillbirth, and maternal mortality. A consistent body of literature has emerged demonstrating an increased risk for insulin resistance and diabetes associated with OSA. However, among pregnant women, the association appears to be related to short sleep duration. Well-designed and adequately powered studies are required to further delineate the role of OSA and sleep duration on pregnancy outcome and the mechanisms of those effects.

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0565 Obstructive Sleep Apnea, But Not Short Sleep Duration, is Independently Associated with Insulin Resistance: A Large-Scale Cohort Study

SLEEP ◽

10.1093/sleep/zsaa056.562 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A216-A217

Author(s):

S Yin ◽

H Xu ◽

J Zou ◽

C Zhang ◽

J Guan ◽

...

Keyword(s):

Insulin Resistance ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sleep Duration ◽

Large Scale ◽

Model Assessment ◽

Short Sleep Duration ◽

Cross Sectional ◽

Short Sleep ◽

Obstructive Sleep

Abstract Introduction Both short sleep duration and obstructive sleep apnea (OSA) seem to be associated with insulin resistance. However, the majority of previous studies addressing the relationship between OSA and insulin resistance did not evaluate short sleep duration, and vice versa. In this study, we used a large-scale hospital-based cross-sectional dataset, including 5,447 participants, to examine 1) whether objectively measured short sleep duration and OSA are independently associated with insulin resistance, and 2) whether the presence of OSA modulates the association between sleep duration and insulin resistance. Methods Participants were consecutively enrolled from our sleep center during the period from 2007 to 2017. The index of homeostasis model assessment insulin resistance (HOMA-IR) was calculated from insulin and glucose. Sleep duration was determined by standard polysomnography. The associations between sleep duration and insulin resistance were estimated by logistic regression analyses. Results A total of 5,447 participants (4507 OSA and 940 primary snorers) were included in the study. In comparison to primary snorers, OSA combined with extremely short sleep duration (< 5 hours) increased the risk of insulin resistance by 34% (OR, 1.34; 95% CI, 1.01-1.77) after adjusting for confounding factors that are frequently associated with insulin resistance and OSA. In subgroup analysis stratified by sleep duration, the risk of insulin resistance in patients with a short sleep duration (5-6 hours or < 5 hours) was increased in those with OSA compared to primary snorers, but not in the other three sleep duration groups (6 - 7, 7 - 8, and > 8 hours). Conclusion OSA, but not short sleep duration, was independently associated with insulin resistance. It is worth noting that OSA combined with extremely short sleep duration showed a greater detrimental effect than OSA itself with regard to insulin resistance. Support This study was supported by grants-in-aid from Shanghai Municipal Commission of Science and Technology (Grant No.18DZ2260200).

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