Obese Women With PCOS Face Higher Sleep Apnea Risk

OB/GYN News, June 15, 2000 by Mitchel L. Zoler

TORONTO -- Obese women with polycystic ovary syndrome face an increased risk of sleep apnea and should be asked about symptoms of the disorder, Dr Robert B. Fogel said at the annual American Lung Association/American Thoracic Society International Conference.

Obstructive sleep apnea it women with polycystic ovary syndrome (PCOS) may be pathophysiologically related to their androgen excess, speculated Dr. Fogel, adding that androgens could affect the airway anatomy, pharyngeal muscle function, and ventilatory control. In turn, obstructive sleep apnea could contribute to the insulin resistance and cardiovascular risk associated with PCOS, said Dr. Fogel, a pulmonary and critical care medicine physician at Massachusetts General Hospital in Boston.

In a study, he compared 18 women with PCOS and a body mass index (BMI) of more than 28 kg/[m.sup.2] and 18 women without PCOS who were matched with the first group for age and BMI.

In addition to the expected differences in serum testosterone levels between the groups, he found that the mean waist-to-hip ratio was significantly higher among the women with PCOS, compared with the women in the control group.

All the women were evaluated for sleep apnea using polysomnography, and completed questionnaires to identify sleeping disorders.

Women with PCOS had significantly higher scores for sleepiness, respiratory disturbance, and apnea hypopnea.

In women with PCOS, 44.4% were diagnosed with obstructive sleep apnea syndrome, defined as having an apnea-hypopnea index of more than 5 and severe daytime sleepiness, Dr. Fogel reported at the meeting, which was held in conjunction with the Canadian Lung Association's annual meeting.

By contrast, 5.5% of the control women were diagnosed with obstructive sleep apnea syndrome, a statistically significant difference.

The parameters most correlated with the severity of the apnea were waist-to-hip ratio and total serum testosterone level. The severity of the apnea did not correlate with age, BMI, neck circumference, or body weight.