Effect of Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea on Insulin Resistance: A Large-Scale Study

Weijun Huang; Yuenan Liu; Xiaoting Wang; Xinyi Li; Yupu Liu; Jianyin Zou; Huajun Xu; Huaming Zhu; Hongliang Yi; Jian Guan; Shankai Yin

doi:10.2147/NSS.S311130

Effect of Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea on Insulin Resistance: A Large-Scale Study

Nat Sci Sleep. 2021 Jun 4:13:739-749. doi: 10.2147/NSS.S311130. eCollection 2021.

Authors

Weijun Huang^#^{1

2

3}, Yuenan Liu^#^{1

2

3}, Xiaoting Wang^{1

2

3}, Xinyi Li^{1

2

3}, Yupu Liu^{1

2

3}, Jianyin Zou^{1

2

3}, Huajun Xu^{1

2

3}, Huaming Zhu^{1

2

3}, Hongliang Yi^{1

2

3}, Jian Guan^{1

2

3}, Shankai Yin^{1

2

3}

Affiliations

¹ Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
² Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.
³ Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Objective: Slow-wave sleep (SWS) and obstructive sleep apnea (OSA) have attracted recent research attention. However, their joint effects on insulin resistance (IR) remain unclear. This study explored whether SWS influences the relationship between OSA and IR.

Methods: We enrolled potential participants in our sleep center from 2007 to 2019. We collected demographic and clinical characteristics and determined IR status. SWS was derived from polysomnography data. Logistic regression analysis was used to reveal the associations between SWS and IR.

Results: In all, 6966 participants (5709 OSA and 1257 primary snoring [PS] subjects) were enrolled. Less SWS increased the risk of IR in OSA patients but not in PS patients. OSA patients with SWS <6.5% were more likely to have IR than were those with SWS >21.3%. OSA was an independent risk factor for IR after adjusting for potential confounding factors. In stratified analyses according to the percentage of SWS, OSA patients with SWS <6.5% had an odds ratio for IR of 2.461 (95% CI, 2.018-3.002) compared to the PS group after adjusting for potential confounders.

Conclusion: Less SWS is associated with higher odds for IR in OSA patients but not in PS patients. OSA is independently associated with IR. In addition, OSA combined with an extreme lack of SWS has a more harmful effect on the status of IR than OSA itself.

Keywords: insulin resistance; obstructive sleep apnea; slow-wave sleep.

Grants and funding

The study was granted by grants from Shanghai Municipal Commission of Science and Technology (Grant No.18DZ2260200), Shanghai Science and Technology Innovation Program of Science and Technology Commission (Grant No. 20Y11902100), National Natural Science Foundation of China (Grant No. 81770988, 81970869) and Shanghai Shen-Kang Hospital Management Center Project (Grant No. SHDC2020CR2044B, SHDC2020CR3056B).