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EFFECT OF SLEEP FRAGMENTATION ON OVERNIGHT OXIDATIVE STRESS, INSULIN, AND GLUCOSE FREE TO VIEW

Mark H. Sanders, MD, FCCP*; Rachel J. Givelber, MD; Jigme M. Sethi, MD; Augustine M. Choi, MD; Valerian Kagan, PhD; Yingze Zhang, PhD; Lynnette Robinson, BS; Christopher P. O'Donnell, PhD; David E. Kelley, MD
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University of Pittsburgh, Pittsburgh, PA



Chest. 2006;130(4_MeetingAbstracts):159S. doi:10.1378/chest.130.4_MeetingAbstracts.159S-a
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Abstract

PURPOSE: Obstructive Sleep Apnea-Hypopnea (OSAH), characterized by sleep fragmentation, cyclic hypoxia and oxidative stress, is linked to altered glycemic control. While sleep restriction is associated with Insulin Resistance (IR), the effect of sleep fragmentation on oxidative stress, Fasting Glucose (FG), Insulin, and IR is undefined.

METHODS: 7 normal subjects (age: 32.4 ± 14.6; BMI: 22.33 ± 1.94) underwent a monitored 4-Night/3-Day protocol. NIGHT 1 Polysomnography (PSG): acclimatization, OSAH screening. NIGHT 2: baseline data collection. NIGHTS 3 and 4: induced sleep fragmentation. Blood was sampled for Low Molecular Weight Thiols (LMWT), a marker of oxidative stress, before and after Nights 2 and 4. FG and Insulin were assessed after Nights 2 and 4 and Homeostasis Model Assessment of IR (HOMA-IR) calculated. Wilcoxon matched-pairs signed-rank test assessed the significance of differences. Data are mean ± SD.

RESULTS: APNEA-HYPOPNEA INDEX: Night 2 = 0.91 ± 0.40; average Nights 3-4 = 1.74 ± 2.08 (p=0.40). AROUSAL INDEX: Night 2 = 3.89 ± 2.13; average Nights 3-4 = 25.29 ± 3.94, (p=0.02). TOTAL SLEEP TIME: Night 2 = 419.1 ± 65.0 min; average Nights 3-4 = 383.52 ± 45.8 min (p=0.04). Mean O2 saturation each night = 97%.LMWT before and after Night 2: 10.8 ± 4.8 μM and 9.4 ± 3.8 μM (p=0.05); before and after Night 4: 11.6 ± 5.9 μM and 9.4 ± 4.1 μM (p=0.02). The overnight change in LMWT between Nights 2 and 4 was not significantly different (p=0.17).FG, INSULIN, and HOMA-IR after Night 2: 89.3 ± 4.8 mg/dl, 11.03 ± 3.96 μU/ml, 2.43 ± 0.89 Units; after Night 4: 87.7 ± 7.3 mg/dl, 11.39 ± 4.11 μU/ml, 2.46 ± 0.96 Units. There were no significant differences noted after Nights 2 and 4.

CONCLUSION: In normal subjects, the overnight sleep period is associated with increased oxidative stress. Moderate sleep fragmentation doesn't augment overnight oxidative stress or alter glycemic control.

CLINICAL IMPLICATIONS: Overnight oxidative stress may exacerbate the impact of pulmonary disorders.Disclosure: MH Sanders is a consultant to Respironics, Inc.

DISCLOSURE: Mark Sanders, None.

Wednesday, October 25, 2006

10:30 AM - 12:00 PM


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