Insulin levels, blood pressure and sleep apnea

• Published in: Sleep (New York, N.Y.) Vol. 17; no. 7; pp. 614 - 618
• Main Authors: STROHL, K. P, NOVAK, R. D, SINGER, W, CAHAN, C, BOEHM, K. D, DENKO, C. W, HOFFSTEIN, V. S
• Format: Journal Article
• Language: English
• Published: Rochester, MN American Academy of Sleep Medicine 01-10-1994
• Subjects: Adult; Analysis of Variance; Biological and medical sciences; Blood Glucose - analysis; Blood Pressure - physiology; Body Mass Index; Body Weight - physiology; Cross-Sectional Studies; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Humans; Insulin - blood; Male; Medical sciences; Middle Aged; Multivariate Analysis; Nervous system (semeiology, syndromes); Neurology; Polysomnography; Risk Factors; Sleep Apnea Syndromes - blood; Sleep Apnea Syndromes - physiopathology; Human; Obesity; Pancreatic hormone; Nervous system diseases; Sleep apnea syndrome; Upper respiratory tract; Body weight; Nutrition disorder; Sleep disorder; Cardiovascular disease; Glucose; Metabolism; Epidemiology; Insulin; Risk factor; Blood pressure; Hemodynamics; Hormonal investigation; Nutritional status
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/17.7.614

This report concerns the relative contributions of body weight and sleep apnea to the following cardiovascular risk factors: blood pressure, fasting insulin and fasting glucose. We cross-sectionally examined the relationship of various levels of apneic activity [apnea-hypopnea index (AHI)] and a measure of obesity [body mass index (BMI)] to mean morning blood pressure and fasting serum insulin and fasting blood glucose concentrations sampled the morning after polysomnography. Subjects were 261 males (age 47 +/- 13 years, mean +/- SD), who were referred to a sleep laboratory for symptoms of sleep-disordered breathing. The dependent variables, mean morning blood pressure, insulin and fasting blood glucose (FBG) levels, were significantly related to both AHI (eta'2 = 0.10) and BMI (eta'2 = 0.18). AHI and BMI combined to account for approximately 30% of the variability in the best linear combination of these three factors. Further analysis indicated that mean morning blood pressure and fasting insulin levels each correlated positively with BMI and AHI, whereas FBG correlated only with BMI. We conclude that, although these data do not prove a causal relationship, there is evidence for an independent association between sleep apnea and not only blood pressure, but also fasting insulin levels.