Abstract
Exposome factors, such as sleep deprivation and diet, could affect skin barrier function. The objectives of this study are to compare skin barrier function between patients with Obstructive Sleep Apnea Syndrome (OSAS) and healthy individuals, and to evaluate the effect of other exposome factors on skin. A cross-sectional study was conducted. Patients with OSAS and healthy volunteers matched by age and sex were included. OSAS severity was assessed by the Apnea-Hypopnea Index (AHI). Validated questionnaires were used to assess diet, anxiety, depression, and psychological stress. Skin barrier function parameters including temperature, erythema, melanin, pH, transepidermal water loss (TEWL), and stratum corneum hydration (SCH) were measured on the volar forearm. A total of 86 participants were included, 56 patients with OSAS and 30 healthy volunteers. TEWL was higher in OSAS patients than in healthy individuals (8.01 vs. 8.68 g·m−2·h−1). Regarding disease severity, severe patients had higher TEWL values (9.31 vs. 8.46 vs. 7.08 g·m−2·h−1) compared to moderate and mild patients. Patients with OSAS had significantly lower sleep quality (11.89 vs. 6.47 Pittsburgh Sleep Quality Index score; p < 0.001), poor adherence to the Mediterranean Diet (8.46 vs. 9.77; p = 0.005), and significantly higher anxiety and depression levels than healthy individuals. In conclusion, patients with OSAS may have skin barrier impairment, reflected in higher TEWL values. These patients also have higher levels of anxiety, depression, stress, and a lower adherence to a Mediterranean Diet, all exposome factors that might impact on skin barrier function.
Highlights
The skin is the largest organ of the body, which acts as a barrier protecting the body from various external agents such as chemical, physical, and environmental stressors [1]
The objectives of this study were (1) to compare cutaneous homeostasis and epidermal barrier function between Obstructive Sleep Apnea Syndrome (OSAS) patients and healthy individuals; (2) to compare cutaneous homeostasis and epidermal barrier function depending on OSAS severity; and (3) to evaluate the effect of other exposome factors on cutaneous homeostasis and epidermal barrier function
Further studies are needed to verify the impact of diet and sleep quality on epidermal barrier function
Summary
The skin is the largest organ of the body, which acts as a barrier protecting the body from various external agents such as chemical, physical (ultraviolet rays), and environmental stressors [1]. To assess and understand the integrity of the skin and its barrier function, a comprehensive evaluation is necessary, which involves assessing different parameters [3]. Some of these parameters are transepidermal water loss (TEWL), stratum corneum hydration (SCH), surface pH, temperature, elasticity, and erythema [4]. TEWL is the most used objective parameter to evaluate skin barrier function. It measures the amount of condensed water that diffuses to the skin surface in a defined area of the stratum corneum per unit of time [5]
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