TY - JOUR T1 - Pharyngeal collapsibility during sleep is elevated in insulin-resistant females with morbid obesity JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00918-2015 SP - ERJ-00918-2015 AU - Oscar L. Llanos AU - Panagis Galiatsatos AU - Edmarie Guzmán-Vélez AU - Susheel P. Patil AU - Philip L. Smith AU - Thomas Magnuson AU - Michael Schweitzer AU - Kimberley Steele AU - Vsevolod Y. Polotsky AU - Alan R. Schwartz Y1 - 2016/04/21 UR - http://erj.ersjournals.com/content/early/2016/04/20/13993003.00918-2015.abstract N2 - Insulin resistance is associated with sleep apnoea, leading us to hypothesise that it is also associated with elevations in pharyngeal collapsibility, even in the absence of sleep apnoea.90 bariatric patients were characterised for sleep apnoea, pharyngeal collapsibility and insulin resistance. Patients with a respiratory disturbance index (RDI) >10 events·h−1, diabetes mellitus, tonsillar hypertrophy and pulmonary disease were excluded. The remaining 14 females underwent collapsibility measurements (passive critical pressure, Pcritp) during non-rapid eye movement sleep. The homeostasis model assessment (HOMA) index, a measure of insulin resistance, was derived from measurements of fasting glucose and insulin levels, and compared to Pcritp.Groups with high Pcritp compared to low Pcritp did not differ in age, body mass index or RDI. HOMA and insulin were elevated in the high Pcritp group compared to the low Pcritp group (p<0.02). Pcritp correlated with HOMA (Spearman's ρ=0.565, 95% CI 0.104–0.862; p=0.035) and insulin (Spearman's ρ=0.609 95% CI 0.196–0.835; p=0.021).Obese insulin-resistant subjects without frank diabetes or sleep apnoea demonstrate preclinical elevations in pharyngeal collapsibility, which may increase their susceptibility to sleep apnoea. Our findings suggest that insulin resistance could play a significant role in sleep apnoea pathogenesis by generating requisite elevations in pharyngeal collapsibility.Insulin resistance elevates pharyngeal collapsibility, thereby increasing susceptibility to sleep apnoea http://ow.ly/XZosr ER -