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Thorax 2008;63:946-950 doi:10.1136/thx.2007.093740
  • Sleep disordered breathing

Insulin resistance and daytime sleepiness in patients with sleep apnoea

  1. A Barceló1,
  2. F Barbé2,
  3. M de la Peña3,
  4. P Martinez4,
  5. J B Soriano4,
  6. J Piérola5,
  7. A G N Agustí3,4,6
  1. 1
    Servei de Anàlisis Cliniques, Hospital Universitari Son Dureta, Palma de Mallorca, Spain
  2. 2
    Servei de Pneumologia, Hospital Arnau de Vilanova, Lleida, Spain
  3. 3
    Servei de Pneumologia, Hospital Universitari Son Dureta, Palma de Mallorca, Spain
  4. 4
    Fundació Caubet-Cimera, Illes Balears, Lleida, Spain
  5. 5
    Unitat de Investigació, Hospital Universitari Son Dureta, Palma de Mallorca, Spain
  6. 6
    CIBER Enfermedades Respiratorias, Lleida, Spain
  1. Dr A Barceló, Servei de Analisis Cliniques, Hospital Universitari Son Dureta, C/ Andrea Doria 55, 07014 Palma de Mallorca, Spain; abarcelo{at}hsd.es
  • Received 20 November 2007
  • Accepted 30 April 2008
  • Published Online First 5 June 2008

Abstract

Background: Excessive daytime sleepiness (EDS), obesity and insulin resistance (IR) occur frequently in patients with obstructive sleep apnoea syndrome (OSAS). We hypothesised that in these patients, EDS is a marker of IR, independent of obesity.

Methods: We studied 44 patients with OSAS (22 with and 22 without EDS) matched for age (±5 years), body mass index (BMI ±3 kg/m2) and severity of OSAS (as determined by the apnoea–hypopnoea index (AHI)), and 23 healthy controls. Patients (n = 35) were re-examined after 3 months of effective therapy with continuous positive airway pressure (CPAP). EDS was assessed by both subjective (Epworth Sleepiness Scale) and objective (Multiple Sleep Latency Test) methods. IR was determined by the HOMA index. Serum levels of glucose, triglycerides, cholesterol, cortisol, insulin, thyrotropin, growth hormone and insulin-like growth factor I (IGF-I) were also determined.

Results: Despite the fact that age, BMI and AHI were similar, patients with EDS had higher plasma levels of glucose (p<0.05) and insulin (p<0.01), as well as evidence of IR (p<0.01) compared with patients without EDS or healthy controls. CPAP treatment reduced cholesterol, insulin and the HOMA index and increased IGF-1 levels in patients with EDS, but did not modify any of these variables in patients without EDS.

Conclusion: EDS in OSAS is associated with IR, independent of obesity. Hence EDS may be a useful clinical marker to identify patients with OSAS at risk of metabolic syndrome.

Footnotes

  • Funding: Supported in part by ABEMAR, SEPAR and Fondo de Investigaciones Sanitarias (04/1593).

  • Competing interests: None declared.

  • Ethics approval: Ethics approval was obtained.

This Article

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  4. All versions of this article:
    1. thx.2007.093740v1
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