Abstract
ObjectivesBoth short sleep duration and obstructive sleep apnea (OSA) seem to be associated with insulin resistance. We aimed to explore whether short sleep duration modifies the relationship between OSA and insulin resistance.MethodsParticipants were consecutively enrolled from our sleep center during the period from 2007 to 2017. The index of homeostasis model assessment insulin resistance (HOMA-IR) was calculated from insulin and glucose. Sleep duration was determined by standard polysomnography. The associations between sleep duration and insulin resistance were estimated by logistic regression analyses.ResultsA total of 5447 participants (4507 OSA and 940 primary snorers) were included in the study. OSA was independently correlated with insulin resistance after adjusting for all potential confounders (OR, 1.319; 95% CI, 1.088–1.599), but not short sleep duration. In stratified analysis by sleep duration, compared with primary snorers, in the OSA group only extremely short sleep duration (< 5 h) was significantly associated with insulin resistance after adjusting for all covariates (OR, 2.229; 95% CI, 1.283–3.874). Rapid eye movement predominant OSA was significantly associated with insulin resistance (OR = 1.355, 95% CI: 1.019–1.802) after adjustment for confounding factors including age, sex and body mass index.ConclusionsOSA, but not short sleep duration, was independently associated with insulin resistance. It is worth noting that OSA combined with extremely short sleep duration showed a greater detrimental effect than OSA itself with regard to insulin resistance.
Highlights
Obstructive sleep apnea (OSA), which is the most common form of sleep-disordered breathing, affects about 34% of men and 17% of women in middle to older age groups [1]
It is worth noting that OSA combined with extremely short sleep duration showed a greater detrimental effect than OSA itself with regard to insulin resistance
Several cross-sectional and longitudinal studies showed that OSA was independently correlated with insulin resistance [11, 12]
Summary
Obstructive sleep apnea (OSA), which is the most common form of sleep-disordered breathing, affects about 34% of men and 17% of women in middle to older age groups [1]. The prevalence of insufficient sleep duration due to bedtime restriction, short-term sleep fragmentation, and sleep deprivation is increasing in modern societies. Both OSA and short sleep duration have attracted a great deal of attention, as they are common globally, and as they are considered to be independent risk factors for cognitive, metabolic, and cardiovascular problems [2,3,4,5,6]. After considering the effect of OSA, sleep duration was not significantly associated with an abnormal fasting glucose level [10]. Considering these inconsistent results, studies on OSA should account for sleep duration and vice versa
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