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- Lindberg, Eva, et al.
(författare)
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Sleep apnea and glucose metabolism : a long-term follow-up in a community-based sample
- 2012
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Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 142:4, s. 935-942
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:It has been suggested that sleep-disordered breathing (SDB) is a risk factor for diabetes, but long-term follow-ups are lacking. The aim of this community-based study was to analyze the influence of SDB on glucose metabolism after more than 10 years.METHODS:Men without diabetes (n=141, mean age 57.5 years) were investigated at baseline, including whole-night respiratory monitoring. After a mean period of 11 years and 4 months, they were followed up with an interview, anthropometric measurements and blood sampling. Insulin resistance was quantified using the homeostasis model assessment (HOMA). ΔHOMA-IR was calculated as (HOMA-IR(follow-up) - HOMA-IR(baseline)). An oral glucose tolerance test was performed in 113 men to calculate the insulin sensitivity index (ISI).RESULTS:The mean apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline were 4.7 and 3.3, respectively. At the follow-up, 23 men had diabetes. An oxygen desaturation index (ODI) of >5 was a predictor of developing diabetes (adj. OR 4.4, 95% CI 1.1-18.1 after adjusting for age, BMI(baseline,) ΔBMI, hypertension and years with CPAP during the period). The ODI was inversely related to the ISI at the follow-up (r= -0.27, p=0.003). A deterioration in HOMA-IR was significantly related to all variables of sleep-disordered breathing (AHI, AHI>5, ODI, ODI>5 and MinSaO2) even when adjusting for confounders. When excluding the variable "years on CPAP" from the multivariate model, all associations weakened.CONCLUSIONS:SDB is independently related to the development of insulin resistance and thereby the risk of manifest diabetes mellitus.
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| 2. |
- Ljunggren, Mirjam, et al.
(författare)
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Association between obstructive sleep apnea and elevated levels of type B natriuretic peptide in a community-based sample of women
- 2012
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 35:11, s. 1521-1527
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives:Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease. One contributory factor may be hemodynamic stress due to the negative intrathoracic pressure during each episode of apnea. Type B natriuretic peptide (BNP) is secreted by the cardiac ventricles in response to volume expansion and pressure load and the authors hypothesized that there would be an association between indices of OSA during the night and levels of BNP in the morning.Setting:Community-based in Uppsala, Sweden.Participants:There were 349 women who participated.Measurements and Results:Participants underwent full-night polysomnography and anthropometric measurements, and answered questionnaires about medical conditions and current medication. The morning after the polysomnography, blood samples were drawn for analysis of plasma BNP, C-reactive protein, creatinine, and hemoglobin. There was an increase in mean BNP as the severity of sleep apnea increased, increasing from a mean value of 8.5 ng/L among women with an apnea-hypopnea index (AHI) < 5 to 18.0 ng/L in women with an AHI = 30. Elevated BNP levels (= 20 ng/L) were found in 29.8% of the women, whereas 70.2% had normal levels. The odds ratio was 2.2 for elevated BNP levels for women with an AHI of 5-14.9 in relation to women with an AHI < 5, 3.1 for women with an AHI of 15-29.9, and 4.6 for women with an AHI = 30 after adjustment for age, body mass index, systolic blood pressure, antihypertensive drugs, and creatinine.Conclusions:There is a dose-response relationship in women between the severity of sleep apnea during the night and the levels of BNP in the morning.
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| 3. |
- Theorell-Haglöw, Jenny, et al.
(författare)
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Sleep duration and central obesity in women : Differences between short sleepers and long sleepers
- 2012
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 13:8, s. 1079-1085
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess characteristics of short sleepers and long sleepers and to assess association between sleep duration and central obesity in a population-based sample of women. Method: Non-pregnant women >= 20 years that were randomly selected from the population-registry of Uppsala, Sweden, answered a questionnaire (n =6461) including questions on sleeping habits and somatic disorders. Results: There was a U-shaped association between sleep duration and waist circumference. Short sleeping women (<5 h) had a waist circumference of 89.2 +/- 14.9 cm (mean +/- SD) decreasing to 82.9 +/- 11.9 cm for women sleeping 7-<8 h and increasing to 89.0 +/- 16.7 cm for women sleeping >= 10 h. Both short sleepers and long sleepers were more often physically inactive, smokers, ill or taking medication, and psychologically distressed than normal sleepers (6-<9 h). In women <50 years both short and long sleep duration were risk factors for central obesity. Short sleep duration remained a risk factor for central obesity, whereas the association with long sleep duration did not reach statistical significance after adjustments. Conclusions: Short sleepers and long sleepers showed differences in characteristics compared to normal sleepers. Furthermore, we showed an independent association between short sleep duration and central obesity, which was strongest in younger women. It is important to identify short sleepers, especially in younger women.
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| 4. |
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| 5. |
- Theorell-Haglöw, Jenny, et al.
(författare)
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What is cause and what is effect?
- 2012
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 13:2, s. 213-213
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Tidskriftsartikel (refereegranskat)
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