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Sleep Apnea Associated With Insulin Resistance in PCOS

SAN FRANCISCO – A high risk for sleep apnea was common in women with polycystic ovary syndrome and was linked to high fasting insulin levels, Dr. Esra Tasali reported at a conference sponsored by the American Diabetes Association.

Among the women with normal glucose tolerance, insulin levels in response to oral glucose were twice as high in women at high risk for sleep apnea, compared with those at low risk. This finding suggests that sleep apnea might worsen the metabolic consequences of insulin resistance, accelerating the conversion from normal to impaired glucose tolerance, Dr. Tasali said.

Although the study does not establish causation, Dr. Tasali recommended that women with polycystic ovary syndrome (PCOS) be systematically evaluated for sleep apnea, as its treatment might improve glucose metabolism.

A high risk for sleep apnea was observed in 30 of 40 women with PCOS, and 92% of the women had sleep problems, according to Dr. Tasali and her colleagues at the University of Chicago (J. Clin. Endocrinol. Metab. 2006;91:36–42).

Of the 40 women, 32 had previously been given an oral glucose tolerance test. Glucose tolerance was normal in 19 women. In 22 women at high sleep apnea risk, average fasting insulin levels were significantly higher (168 pmol/L) than they were in the 10 women at low apnea risk (97 pmol/L). Among the 13 women with impaired glucose tolerance, glucose and insulin levels did not differ depending on the level of apnea risk.

Another cohort of eight women with PCOS underwent overnight polysomnography for symptoms suggestive of obstructive sleep apnea. Mean sleep efficiency was 80% in the women with PCOS, compared with 92% in a control group of age-matched, nonobese women. The women with PCOS also had significantly longer mean sleep latency (41 minutes vs. 10 minutes), and significantly shorter total sleep time (323 minutes vs. 442 minutes, a difference of almost 2 hours).

“Sleep apnea might be an intrinsic component of the metabolic disturbances that appear with” PCOS, Dr. Tasali said.

Furthermore, severity of sleep apnea as measured by the apnea-hypopnea index, and the degree of oxygen desaturations during rapid-eye-movement sleep, accounted for more than 90% of the variability in measures of glucose tolerance including hemoglobin A1c levels.

Dr. Tasali had no conflict of interest to report regarding her presentation.

Women withPCOS should be evaluated for sleep apnea, as its treatment might improve glucose metabolism. DR. TASALI

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SAN FRANCISCO – A high risk for sleep apnea was common in women with polycystic ovary syndrome and was linked to high fasting insulin levels, Dr. Esra Tasali reported at a conference sponsored by the American Diabetes Association.

Among the women with normal glucose tolerance, insulin levels in response to oral glucose were twice as high in women at high risk for sleep apnea, compared with those at low risk. This finding suggests that sleep apnea might worsen the metabolic consequences of insulin resistance, accelerating the conversion from normal to impaired glucose tolerance, Dr. Tasali said.

Although the study does not establish causation, Dr. Tasali recommended that women with polycystic ovary syndrome (PCOS) be systematically evaluated for sleep apnea, as its treatment might improve glucose metabolism.

A high risk for sleep apnea was observed in 30 of 40 women with PCOS, and 92% of the women had sleep problems, according to Dr. Tasali and her colleagues at the University of Chicago (J. Clin. Endocrinol. Metab. 2006;91:36–42).

Of the 40 women, 32 had previously been given an oral glucose tolerance test. Glucose tolerance was normal in 19 women. In 22 women at high sleep apnea risk, average fasting insulin levels were significantly higher (168 pmol/L) than they were in the 10 women at low apnea risk (97 pmol/L). Among the 13 women with impaired glucose tolerance, glucose and insulin levels did not differ depending on the level of apnea risk.

Another cohort of eight women with PCOS underwent overnight polysomnography for symptoms suggestive of obstructive sleep apnea. Mean sleep efficiency was 80% in the women with PCOS, compared with 92% in a control group of age-matched, nonobese women. The women with PCOS also had significantly longer mean sleep latency (41 minutes vs. 10 minutes), and significantly shorter total sleep time (323 minutes vs. 442 minutes, a difference of almost 2 hours).

“Sleep apnea might be an intrinsic component of the metabolic disturbances that appear with” PCOS, Dr. Tasali said.

Furthermore, severity of sleep apnea as measured by the apnea-hypopnea index, and the degree of oxygen desaturations during rapid-eye-movement sleep, accounted for more than 90% of the variability in measures of glucose tolerance including hemoglobin A1c levels.

Dr. Tasali had no conflict of interest to report regarding her presentation.

Women withPCOS should be evaluated for sleep apnea, as its treatment might improve glucose metabolism. DR. TASALI

SAN FRANCISCO – A high risk for sleep apnea was common in women with polycystic ovary syndrome and was linked to high fasting insulin levels, Dr. Esra Tasali reported at a conference sponsored by the American Diabetes Association.

Among the women with normal glucose tolerance, insulin levels in response to oral glucose were twice as high in women at high risk for sleep apnea, compared with those at low risk. This finding suggests that sleep apnea might worsen the metabolic consequences of insulin resistance, accelerating the conversion from normal to impaired glucose tolerance, Dr. Tasali said.

Although the study does not establish causation, Dr. Tasali recommended that women with polycystic ovary syndrome (PCOS) be systematically evaluated for sleep apnea, as its treatment might improve glucose metabolism.

A high risk for sleep apnea was observed in 30 of 40 women with PCOS, and 92% of the women had sleep problems, according to Dr. Tasali and her colleagues at the University of Chicago (J. Clin. Endocrinol. Metab. 2006;91:36–42).

Of the 40 women, 32 had previously been given an oral glucose tolerance test. Glucose tolerance was normal in 19 women. In 22 women at high sleep apnea risk, average fasting insulin levels were significantly higher (168 pmol/L) than they were in the 10 women at low apnea risk (97 pmol/L). Among the 13 women with impaired glucose tolerance, glucose and insulin levels did not differ depending on the level of apnea risk.

Another cohort of eight women with PCOS underwent overnight polysomnography for symptoms suggestive of obstructive sleep apnea. Mean sleep efficiency was 80% in the women with PCOS, compared with 92% in a control group of age-matched, nonobese women. The women with PCOS also had significantly longer mean sleep latency (41 minutes vs. 10 minutes), and significantly shorter total sleep time (323 minutes vs. 442 minutes, a difference of almost 2 hours).

“Sleep apnea might be an intrinsic component of the metabolic disturbances that appear with” PCOS, Dr. Tasali said.

Furthermore, severity of sleep apnea as measured by the apnea-hypopnea index, and the degree of oxygen desaturations during rapid-eye-movement sleep, accounted for more than 90% of the variability in measures of glucose tolerance including hemoglobin A1c levels.

Dr. Tasali had no conflict of interest to report regarding her presentation.

Women withPCOS should be evaluated for sleep apnea, as its treatment might improve glucose metabolism. DR. TASALI

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