title: The relationship between excessive daytime sleepiness and metabolic syndrome in severe obstructive sleep apnea syndrome.
abstract: BACKGROUND
  Excessive daytime sleepiness (EDS), which is commonly considered a cardinal sign of obstructive sleep apnea (OSA), may lead to an increased rate of metabolic syndrome (MetS), and be an independent risk factor for cardiovascular morbidity and mortality. The aim of this cross-sectional study was to examine the role of EDS in MetS and its components by researching severe OSA patients.
  
  
  METHODS
  The records of 175 consecutive patients who underwent standard polysomnography and diagnosed severe OSA were included. Subjective daytime sleepiness was assessed using the Epworth sleepiness scale (ESS). Fasting glucose, lipids, insulin and polysomnography parameters were measured. A metabolic score was counted as the total number of the positive diagnostic criteria of MetS for each subject, which indicated the level of metabolic disorder.
  
  
  RESULTS
  The prevalence of central obesity, hypertriglyceridemia, low high density lipoprotein-cholesterol and MetS (78.2% vs 28.6%) was significantly higher among EDS group compared with control group. Compared with non-EDS patients, patients with EDS showed significantly higher metabolic score (3.22 ± 0.94 vs 1.96 ± 1.06). After adjustment for confounders, ESS score, log insulin and age significantly predicted the metabolic score (β = 0.567, P = 0.000; β = 0.197, P = 0.001 and β = 0.118, P = 0.048, respectively).
  
  
  CONCLUSIONS
  EDS was independently correlated with the sum of metabolic components in severe OSA patients. Our study suggested that EDS might be a potentially useful clinical marker to identify patients with severe OSA at risk of MetS.
authors: Fujian Provincial Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Jie-Feng
authors: JF
authors: Huang
authors: Department of Respiratory Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
authors: Li-Da
authors: LD
authors: Chen
authors: Fujian Provincial Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China. chang4e@126.com.
authors: Qi-Chang
authors: QC
authors: Lin
authors: Fujian Provincial Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Gong-Ping
authors: GP
authors: Chen
authors: Fujian Provincial Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Yao-Hua
authors: YH
authors: Yu
authors: Fujian Provincial Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Jian-Chai
authors: JC
authors: Huang
authors: Fujian Provincial Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Jian-Ming
authors: JM
authors: Zhao
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology
keywords: excessive daytime sleepiness; hypoxemia; metabolic syndrome; obstructive sleep apnea