title: Sleepiness as a marker of glucose deregulation in obstructive sleep apnea.
abstract: BACKGROUND
  Excessive daytime sleepiness (EDS) is a major but not universally present feature of obstructive sleep apnea syndrome (OSAS). The latter has been associated with glucose dysmetabolism and insulin resistance. The aim of this study was to examine the role of EDS by investigating potential differences between somnolent and non-somnolent OSAS patients in glucose metabolism, insulin resistance, and levels of cardiovascular risk factors.
  
  
  METHODS
  Included were 25 newly diagnosed otherwise healthy OSAS patients, reporting EDS (ESS ≥ 11) and 25 age- and BMI-matched, non-somnolent (ESS ≤ 10) OSAS patients, who served as controls. Fasting glucose and insulin levels, as well as homeostatic model assessment of insulin resistance (HOMA(IR)) index, levels of hs-CRP, and lipidemic profile were measured.
  
  
  RESULTS
  The two groups did not differ in anthropometric or sleep characteristics. A significant correlation of ESS with glucose (p = 0.004), insulin (p = 0.011), and HOMA(IR) (p = 0.031) was observed. Somnolent patients had higher levels of glucose (p = 0.045), insulin (p = 0.012), and HOMA(IR) (p = 0.027). No difference was detected in other markers between the two groups.
  
  
  CONCLUSIONS
  Daytime sleepiness in OSAS patients is associated with hyperglycemia and hyperinsulinemia. These results suggest its potential use as a surrogate marker of insulin resistance in such patients.
authors.affiliation: Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece. evangelianena@yahoo.gr
authors.forename: Evangelia
authors.initials: E
authors.lastname: Nena
authors.forename: Paschalis
authors.initials: P
authors.lastname: Steiropoulos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papanas
authors.forename: Venetia
authors.initials: V
authors.lastname: Tsara
authors.forename: Christina
authors.initials: C
authors.lastname: Fitili
authors.forename: Marios E
authors.initials: ME
authors.lastname: Froudarakis
authors.forename: Efstratios
authors.initials: E
authors.lastname: Maltezos
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Bouros
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000503:physiopathology; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012016:Reference Values; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids