Effect of sleep apnea syndrome on the circadian profile of cortisol in obese men

2007 ◽  
Vol 293 (2) ◽  
pp. E466-E474 ◽  
Author(s):  
F. Dadoun ◽  
P. Darmon ◽  
V. Achard ◽  
S. Boullu-Ciocca ◽  
F. Philip-Joet ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Salivary Cortisol ◽  
Repeated Measures ◽  
Plasma Cortisol ◽  
Sleep Apnea Syndrome ◽  
Visceral Obesity ◽  
Normal Weight ◽  
Apnea Hypopnea Index ◽  
Apnea Syndrome ◽  
Cortisol Levels

It has been hypothesized that sleep apnea syndrome (SAS) increases hypothalamic-pituitary-adrenal axis activity and, through increased cortisol levels, participates in the pathophysiology of metabolic and cardiovascular complications. We compared the circadian profiles of cortisol in obese men with [obSAS+; apnea-hypopnea index (AHI) ≥ 20/h] and without SAS (obSAS−; AHI ≤ 5/h). 1) Salivary cortisol (5 samples: before/30 min after dinner, 2100, upon/30 min after awakening) was measured in 15 obSAS+, 19 obSAS−, and 19 normal-weight controls (NWC). 2) Plasma cortisol (every 30 min for 24 h under highly controlled conditions and portable EEG device) was measured in 9 obSAS+, 8 obSAS−, and 10 NWC men. Visceral adipose tissue surface was measured by CT scan. In both studies, obSAS+ and obSAS− men were comparable for age, BMI, waist circumference, and waist-to-hip ratio. First, no difference was found, using ANOVA for repeated measures, between obSAS+ and obSAS− subjects for any salivary cortisol measurement. No correlation was found between salivary cortisol and AHI or nocturnal SaO2. Similarly, obSAS+ and obSAS− men showed no difference in plasma cortisol rhythmicity: 24-h minimum, maximum, and mean, ANOVA for repeated measures, mathematical modeling of cortisol rhythm (COSINOR), and morning secretory peak. Conversely, ANOVA for repeated measures showed decreased cortisol levels in obese vs. NWC men during both the trough (2200–0130) and the peak (0600–0900) independently of SAS status. We show that SAS per se is not associated with any change of the level or of the features of salivary and plasma cortisol rhythmicity and confirm that men with visceral obesity display lower plasma cortisol levels than NWC men.

scholarly journals Predictors of visceral obesity in normal weight obstructive sleep apnea patients

2019 ◽  
Vol 16 (2) ◽  
pp. 29-35
Author(s):  
Tatyana O. Brodovskaya ◽  
Egor A. Kovin ◽  
Oxana V. Bazhenova ◽  
Irina F. Grishina ◽  
Tatiana F. Peretolchina
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Visceral Obesity ◽  
Normal Weight ◽  
Main Group ◽  
Control Group ◽  
Obstructive Sleep ◽  
Normal Body Weight ◽  
Apnea Syndrome

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is epidemiologically related to adverse cardiovascular outcomes. The pathophysiology clues are metabolic changes and obesity. The most studied anthropometric predictors of obesity, such as body mass index (BMI), waist circumference (WC), are influenced by various factors such as sex, type of constitution, hydration balance. The normal range of BMI and WC limits the diagnostic search for metabolic disturbances and visceral obesity in patients with respiratory sleep distress and can lead to increased cardiovascular risks. AIMS: to investigate the visceral obesity predictors in normal weight patients with obstructive sleep apnea syndrome. MATERIALS AND METHODS: We had performed а cross-sectional study, 68 patients were examined with mean age of 38.24 7.4 years. The main group (38 individuals) was represented by patients with OSAS. The control group consisted of healthy individuals without OSAS. Alternative markers of visceral obesity, such as lipid accumulation products, visceral obesity index, conicity index have been studied. RESULTS: In the main group we found different disorders of lipid metabolism such as the increase in triglyceride levels by 94%, low-density lipids by 32%, total cholesterol by 10% compared with the control group. Anthropometric evidence was obtained for excessive fat accumulation in patients with normal body weight and OSAS: WC was 89.6 5.7 cm in the main group and was higher than in the control group 83.7 6.3 cm (p = 0.024) due to an increase in the visceral fat compartment, as evidenced by the conicity index (67.2 7.0 and 59.3 6.2 respectively, p = 0.032) and waist to height ratio (0.58 0.05 and 0.53 0.04 in the main and control groups, respectively, p = 0.041). Correlation relationships between the severity of sleep apnea syndrome and visceral obesity indicators were revealed. CONCLUSIONS: Normal weight patients with breathing disorders are at risk of visceral fat obesity and, thereby, increased cardiovascular risk. Assessment of additional markers of visceral obesity in patients with normal body weight and sleep apnea is recommended to include in the dynamic observation programms.

Changes in salivary cortisol levels in pediatric patients with obstructive sleep apnea syndrome after adenotonsillectomy

2014 ◽  
Vol 15 (6) ◽  
pp. 672-676 ◽  
Author(s):  
Jong-Hyun Jeong ◽  
Christian Guilleminault ◽  
Chan-Soon Park ◽  
Hye-Lim Son ◽  
Heung-Ku Lee ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Salivary Cortisol ◽  
Pediatric Patients ◽  
Sleep Apnea Syndrome ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Cortisol Levels

scholarly journals Detecting Apnea/Hypopnea Events Time Location from Sound Recordings for Patients with Severe or Moderate Sleep Apnea Syndrome

2021 ◽  
Vol 11 (15) ◽  
pp. 6888
Author(s):  
Georgia Korompili ◽  
Lampros Kokkalas ◽  
Stelios A. Mitilineos ◽  
Nicolas-Alexander Tatlas ◽  
Stelios M. Potirakis
Keyword(s):  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Event Time ◽  
Severity Estimation ◽  
Apnea Duration ◽  
Respiratory Events ◽  
Moderate Sensitivity ◽  
Apnea Syndrome

The most common index for diagnosing Sleep Apnea Syndrome (SAS) is the Apnea-Hypopnea Index (AHI), defined as the average count of apnea/hypopnea events per sleeping hour. Despite its broad use in automated systems for SAS severity estimation, researchers now focus on individual event time detection rather than the insufficient classification of the patient in SAS severity groups. Towards this direction, in this work, we aim at the detection of the exact time location of apnea/hypopnea events. We particularly examine the hypothesis of employing a standard Voice Activity Detection (VAD) algorithm to extract breathing segments during sleep and identify the respiratory events from severely altered breathing amplitude within the event. The algorithm, which is tested only in severe and moderate patients, is applied to recordings from a tracheal and an ambient microphone. It proves good sensitivity for apneas, reaching 81% and 70.4% for the two microphones, respectively, and moderate sensitivity to hypopneas—approx. 50% were identified. The algorithm also presents an adequate estimator of the Mean Apnea Duration index—defined as the average duration of the detected events—for patients with severe or moderate apnea, with mean error 1.7 s and 3.2 s for the two microphones, respectively.

scholarly journals Effect of a Graduated Walking Program on the Severity of Obstructive Sleep Apnea Syndrome. A Randomized Clinical Trial

2020 ◽  
Vol 17 (17) ◽  
pp. 6334
Author(s):  
Antonio Jurado-García ◽  
Guillermo Molina-Recio ◽  
Nuria Feu-Collado ◽  
Ana Palomares-Muriana ◽  
Adela María Gómez-González ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Intervention Group ◽  
Exercise Program ◽  
Density Lipoprotein ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Background: Obstructive sleep apnea syndrome (OSAS) is a common disease. The objective of this research was to determine the effectiveness of a graduated walking program in reducing the apnea–hypopnea index number in patients with obstructive sleep apnea syndrome (OSAS). Methods: A randomized controlled clinical trial with a two-arm parallel in three tertiary hospitals was carried out with seventy sedentary patients with moderate to severe OSAS. Twenty-nine subjects in each arm were analyzed by protocol. The control group received usual care, while usual care and an exercise program based on progressive walks without direct supervision for 6 months were offered to the intervention group. Results: The apnea–hypopnea index decreased by six points in the intervention group, and improvements in oxygen desaturation index, total cholesterol, and Low-Density Lipoprotein of Cholesterol (LDL-c) were observed. A higher decrease in sleep apnea–hypopnea index (45 ± 20.6 vs. 34 ± 26.3/h; p = 0.002) was found in patients with severe vs. moderate OSAS, as well as in oxygen desaturation index from baseline values (43.3 vs. 34.3/h; p = 0.046). Besides, High-Density Lipoprotein of Cholesterol (HDL-c) values showed a higher increase in the intervention group (45.3 vs. 49.5 mg/dL; p = 0.009) and also, a higher decrease in LDL-c was found in this group (141.2 vs. 127.5 mg/dL; p = 0.038). Conclusion: A home physical exercise program is a useful and viable therapeutic measure for the management of OSAS.

scholarly journals Different Impacts of Neck Circumference and Visceral Obesity on the Severity of Obstructive Sleep Apnea Syndrome

Obesity ◽  
2011 ◽  
Vol 19 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Yuji Kawaguchi ◽  
Shinya Fukumoto ◽  
Masaaki Inaba ◽  
Hidenori Koyama ◽  
Tetsuo Shoji ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Visceral Obesity ◽  
Neck Circumference ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Lateral-Expansion Pharyngoplasty: Combined Technique for the Treatment of Obstructive Sleep Apnea Syndrome

2019 ◽  
Vol 24 (01) ◽  
pp. e107-e111 ◽  
Author(s):  
José Antonio Pinto ◽  
Luciana Balester Mello de Godoy ◽  
Heloisa dos Santos Sobreira Nunes ◽  
Kelly Elia Abdo ◽  
Gabriella Spinola Jahic ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Surgical Techniques ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Lateral Expansion ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Abstract Introduction Obstructive sleep apnea syndrome (OSAS) is a multifactorial disease characterized by episodes of partial or complete collapse during sleep of different regions of the upper airway. Surgery for OSAS evolved with the introduction of different techniques, considering new surgical concept of reconstruction of the upper airway. Objective To retrospectively evaluate the effectiveness of a new approach aimed at reducing pharyngeal collapse by combining two surgical techniques: lateral and expansion pharyngoplasty. Methods We reviewed the medical records of 38 patients with OSAS undergoing lateral/expansion pharyngoplasty from January 2012 to December 2016. The following data were collected: patient age, gender, and pre- and postoperative body mass index (BMI), Epworth sleepiness scale (ESS) scores, snoring visual analogue scale (VAS) scores, and polysomnography (PSG) results. Results The PSG results showed a significant reduction in the apnea/hypopnea index (AHI) from 22.4 ± 27.3 events/h preoperatively to 13.6 ± 17.9 events/h postoperatively (p = 0.009), with postoperative AHI reduction greater than 50% in 63.2% of the patients. There was also a significant reduction in the microarousal index (19.5 ± 22.6 vs 11.0 ± 13.4 events/h; p = 0.001) and in the minimum oxygen saturation (82.6 ± 10.3 vs 86.9 ± 11.1; p = 0.007). Conclusions Lateral-expansion pharyngoplasty represents a new surgical strategy for the treatment of OSAS in patients with palatal collapse by combining two different techniques: lateral and expansion pharyngoplasty. The two techniques, performed as a one-stage procedure, led to improvements in excessive daytime sleepiness, snoring, and PSG respiratory parameters by acting on lateral and retropalatal collapse, producing favorable results with good applicability in otolaryngology clinical practice.

scholarly journals Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome

2015 ◽  
Vol 30 (1) ◽  
pp. 17-23
Author(s):  
Nikki Lorraine Y. King-Chao ◽  
Michael A. Sarte
Keyword(s):  
Body Mass Index ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Obese Patients ◽  
Apnea Syndrome

Objective: To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI. Methods: Study Design:            Non-Concurrent Cohort Study Setting:                       Tertiary Private Hospital Population:                The charts of 389 patients suspected to have sleep disorders and referred for polysomnography (PSG) at the Center for Snoring and Sleep Disorders in year 2009 were reviewed. Inclusion criteria were patients aged 19 and above with complete data. A total of 238 patient charts were included in the study. Results:The study included a total of 238 patient charts. Results showed no significant association between ESS and AHI (p-value >0.05), even when correlated with the different severities of OSAS (p-value>0.05). Sensitivity and specificity of ESS was found to be 54% and 57%, respectively, indicating that ESS is not a sensitive and specific tool to predict the presence of OSAS. These findings suggest that ESS may not be able to significantly identify patients with OSAS. However, BMI showed a significant association with ESS (p-value<0.05), representing more patients with EDS belonging to the obese category. Conversely, obese patients were twice more likely to have EDS, represented by ESS scores of ³10. BMI wasalso significantly associated with AHI using one-way Anova test. Conclusion: This report concludes that the ESS alone is insufficient to identify patients with OSAS. Nevertheless, questionnaires like the ESS supplement relevant history to help diagnose patients with sleep disorders, particularly OSAS. On the other hand, the ESS showed a significant association with BMI, representing more obese patients had excessive daytime sleepiness. The likelihood ratio of having excessive daytime sleepiness is 2 times more for obese patients. BMI was also significantly associated with AHI, which confirms the well established relationship of obesity with OSAS, and shows that obese patients are at higher risk for severe OSAS. Keywords:obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index,  body-mass index.

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