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Risk for sleep apnea doubles in women with Cushing’s syndrome
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Women with active Cushing’s syndrome are twice as likely to develop obstructive sleep apnea vs. women without the disease, according to recent findings.
“In this study, we found that cortisol levels were strongly associated with [apnea–hypopnea index] even after controlling for [homeostatic model assessment] scores,” Hulusi Atmaca, MD, professor of endocrinology at Ondokuz Mayis University Medical School in Samsun, Turkey, and colleagues wrote. “This finding clearly supports the role of hypercortisolism in the pathogenesis of [obstructive sleep apnea].”
Atmaca and colleagues analyzed data from 30 women with newly diagnosed and untreated Cushing’s syndrome between January 2014 and August 2015 (mean age, 46 years; mean BMI, 32 kg/m²; five with type 2 diabetes; four with hypertension), as well as 30 age- and BMI-matched controls (six with hypertension). All women underwent standard all-night polysomnography and provided fasting blood samples for serum cortisol, glucose and insulin measurements. Obstructive sleep apnea was graded as mild (apnea-hypopnea index [AHI], 5-15), moderate (AHI, 15-30) or severe (AHI 30).
The researchers found that women with Cushing’s syndrome were more likely to have obstructive sleep apnea and more symptomatic sleep apnea vs. controls (50% vs. 23%; P = .003), as well as higher mean AHI scores vs. controls (P = .005). Most patients in the cohort had mild sleep apnea (14 with Cushing’s syndrome; seven controls).
AHI was positively correlated with HOMA score (r = 0.281; P = .046) in patients with Cushing’s syndrome and controls, and serum cortisol was an independent predictor of AHI after controlling for BMI and HOMA scores, according to researchers.
“The finding of high frequency of [obstructive sleep apnea] in patients with [Cushing’s syndrome] should be considered a risk factor for the increased mortality and morbidity and decreased quality of life,” the researchers wrote. “[Obstructive sleep apnea] has not been recognized as a typical comorbidity of [Cushing’s syndrome], even in the recent literature. It can also be a contributory factor for the other comorbid conditions of [Cushing’s syndrome]. This study will shed light on these obscure issues.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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