S. Magnusdottir, R.J. Thomas, H. Hilmisson. Can improvements in sleep quality positively affect serum adiponectin-levels in patients with obstructive sleep apnea? Sleep Medicine [Epub ahead of print]. DOI: 10.1016/j.dlrrp.2021.05.032
Sleep is an important modulator of neuroendocrine function and poor sleep has been correlated with metabolic and endocrine alterations, including decreased levels of insulin sensitivity as well as alterations in levels of the appetite-regulating hormones leptin and ghrelin. This study evaluated if changes in sleep quality (Sleep Quality Index, SQI) based on cardiopulmonary coupling-analysis (CPC) impacts serum adiponectin levels in patients with obstructive sleep apnea (OSA) and cardiovascular disease (CVD).
Improving SQI improves serum adiponectin-levels 2.69 mg/ml (p=0.005) irrespective of therapy initiated. After controlling for confounders, a unit increase in SQI was associated with increase in serum adiponectin-levels 0.071 mg/ml (p=0.012) and decrease in insulin-levels 0.197 µIU/ml (p=0.0018).
In patients receiving CPAP-therapy, a difference of 3.82 mg/ml (p=0.025) is observed comparing patients in which SQI-improved to patients that SQI-declined. The difference was mostly due to a decrease in serum adiponectin levels in patients that decline in SQI (-3.20 mg/ml).
Adiponectin has an important function to protect from the development of metabolic disease and works through multiple pathways, anti-inflammatory, is anti-atherogenic and promotes insulin sensitivity. Hypoadiponectinemia is associated with endothelial dysfunction, obesity and increased cardiovascular morbidity. Methods enhancing or restoring serum adiponectin levels, like improving SQI, may have positive effects on metabolic disease. In treatment of OSA with CPAP, improving not only AHI but additionally SQI should improve cardiovascular outcomes.