Association of apnea-hypopnea index during rapid eye movement sleep with insulin resistance in patients with suspected obstructive sleep apnea: a cross-sectional study.

Content Provider	Europe PMC
Author	Zou, Juanjuan Liu, Yupu Xu, Huajun Meng, Lili Zou, Jianyin Qian, Yingjun Chen, Bin Yi, Hongliang Guan, Jian Yin, Shankai
Copyright Year	2021
Abstract	BackgroundObstructive sleep apnea (OSA) is associated with insulin resistance. However, the association between special stages of OSA [rapid eye movement (REM) sleep] and insulin resistance is not clear. This study was designed to assess the association of the frequency of respiratory events during REM sleep with insulin resistance in adults with suspected OSA.MethodsIn this cross-sectional study, 4,062 adult participants with suspected OSA who underwent polysomnography in our sleep center between 2009 and 2016 were screened. Polysomnographic variables, biochemical indicators, and physical measurements were collected. Logistic regression analyses were conducted to determine the odds ratios (ORs) and 95% confidence intervals (95% CIs) for insulin resistance as assessed by the presence of hyperinsulinemia, the homeostasis model assessment of insulin resistance (HOMA-IR) index, the fasting insulin resistance index (FIRI), and Bennett’s insulin sensitivity index (ISI).ResultsThe final analyses included 2,899 adults with suspected OSA. Multivariate adjustments, including the apnea-hypopnea index (AHI) during non-REM sleep (AHINREM), were performed. The AHI during REM sleep (AHIREM) was found to be independently associated with insulin resistance across increasing AHIREM quartiles. For hyperinsulinemia the ORs (95% CIs) followed the order of 1.340 (1.022, 1.757), 1.210 (0.882, 1.660), and 1.632 (1.103, 2.416). For abnormal HOMA-IR, ORs (95% CIs) were 1.287 (0.998, 1.661), 1.263 (0.933, 1.711), and 1.556 (1.056, 2.293). For abnormal FIRI, ORs (95% CIs) were 1.386 (1.048, 1.835), 1.317 (0.954, 1.818), and 1.888 (1.269, 2.807). For abnormal Bennett’s ISI, ORs (95% CIs) were 1.297 (1.003, 1.678), 1.287 (0.949, 1.747), and 1.663 (1.127, 2.452). All linear trends were statistically significant (P<0.01). Additionally, the results showed that REM sleep duration was independently associated with hyperinsulinemia (OR =0.777, 95% CI: 0.615–0.982; P<0.05).ConclusionsAHIREM was independently associated with hyperinsulinemia and an abnormal HOMA-IR, FIRI, and Bennett’s ISI in adults with suspected OSA. Additionally, REM sleep duration was independently associated with hyperinsulinemia.
ISSN	23055839
Volume Number	9
PubMed Central reference number	PMC7940895
Issue Number	3
PubMed reference number	33708870
Journal	Annals of Translational Medicine [Ann Transl Med]
e-ISSN	23055847
DOI	10.21037/atm-20-3165
Language	English
Publisher	AME Publishing Company
Publisher Date	2021-02-01
Access Restriction	Open
Rights License	Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0. 2021 Annals of Translational Medicine. All rights reserved.
Subject Keyword	Obstructive sleep apnea (OSA) rapid eye movement sleep (REM sleep) sleep duration insulin resistance
Content Type	Text
Resource Type	Article
Subject	Medicine