Skip to main content
SpringerLink
Log in

Obstructive sleep apnea syndrome. Effects of therapy on dyslipidemia

Obstruktives Schlafapnoe Syndrom. Einfluss einer Therapie auf Fettstoffwechselstörungen

  • Original Articles
  • Published:
Somnologie - Schlafforschung und Schlafmedizin Aims and scope Submit manuscript

Summary

Objective

Dyslipidemia is frequently observed in patients with obstructive sleep apnea syndrome (OSAS). The effects of OSAS treatment on lipid levels in these patients have been examined.

Patients and Methods

95 consecutive patients (aged 56.6±9.5 years) with polysomnographically verified OSAS and LDL cholesterol levels of more than 130 mg per deciliter have been included in a prospective trial. Plasma total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride, apolipoprotein B, and lipoprotein (a) levels were determined in all patients at baseline and after long term therapy.

Results

Total cholesterol (249.9±31.4 vs. 240.0±34.1 mg/dL; p=0.01) and LDL cholesterol levels (179.4±29.4 vs. 165.5±32.5 mg/dL; p<0.001) decreased significantly after 6 months in patients effectively treated, while they did not change significantly in those OSAS patients in whom treatment proved to be ineffective. Body mass index, HDL cholesterol, triglyceride, apolipoprotein B, and lipoprotein (a) levels did not change during follow-up. Both the change of total and LDL cholesterol levels were independently associated with treatment efficacy as indicated by the change of the apnea/hypopnea index.

Conclusion

The results suggest that effective treatment of sleep-disordered breathing may have significant effects on the total and LDL cholesterol levels in OSAS patients.

Zusammenfassung

Einführung

Fettstoffwechselstörungen werden häufig bei Patienten mit obstruktivem Schlafapnoe Syndrom (OSAS) beobachtet. Die vorliegende prospektive Studie untersuchte den Einfluß einer schlafmedizinischen Therapie auf den Lipidmetabolismus bei OSAS-Patienten.

Patienten und Methodik

95 konsekutive Patienten (Alter 56.5±9.5 Jahre) mit polysomnographisch gesichertem OSAS und einem LDL-Cholesterinspiegel von >130 mg/dl wurden in die vorliegende Studie aufgenommen. Bei allen Patienten wurden zum Ausgangszeitpunkt und nach einer OSAS-Langzeittherapie Gesamtcholesterin, high-density lipoprotein (HDL) Cholesterin, low-density lipoprotein (LDL) Cholesterin, Triglyzeride, Apolipoprotein B sowei Lipoprotein (a) bestimmt.

Ergebnisse

Das Gesamtcholesterin (249,9±31,4 vs. 240,0±34,1 mg/dl; p=0,01) sowie das LDL-Cholesterin (179,4±29,4 vs. 165,5±32,5 mg/dl; p<0,001) sanken signifikant nach 6 Monaten unter effektiver Therapie, wohingegen sie sich bei den ineffektiv behandelten Patienten nicht signifikant änderten. Der Body Mass Index, das HDL-Cholesterin, die Triglyzeride, das Apolipoprotein B sowie das Lipoprotein (a) blieben im Verlauf unverändert. Sowohl die Änderung des Gesamt-als auch die des LDL-Cholesterins waren unabhängig mit der Therapieeffizienz, gemessen an der Änderung des Apopnoe/Hypopnoe Index (AHI), assoziiert.

Schlussfolgerungen

Diese Ergebnisse deuten darauf hin, dass eine effektive schlafmedizinische Therapie bei OSAS-Patienten einen signifikanten Einfluss auf den Gesamt-und LDL-Cholesterinspiegel ausüben kann.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. American Academy of Sleep Medicine Task Force: Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research. Sleep 22: 667–689, 1999.

    Google Scholar 

  2. American Thoracie Society—Medical Section of the American Lung Association: Indications and standards for cardiopulmonary sleep studies. Am Rev Respir Dis 139:559–568, 1989.

    Google Scholar 

  3. Bjorntorp P: Obesity. Lancet 350: 423–426, 1997.

    CAS  Google Scholar 

  4. Carlson JT, Hedner J, Elam M, et al.: Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest 103: 1763–1768, 1993.

    PubMed  CAS  Google Scholar 

  5. Chin K, Shimizu K, Nakamura T et al.: Changes in intra-abdominal visceral fat and serum leptin levels in patients with obstructive sleep apnea syndrome following nasal continuous positive airway pressure therapy. Circulation 100: 706–712, 1999.

    PubMed  CAS  Google Scholar 

  6. Friedewald WT, Levy RI, Fredrickson DS: Estimation of the concentration of low-density lipoprotein cholesterol in plasma. without use of the preparative ultracentrifuge. Clin Chem 18: 499–502, 1972.

    PubMed  CAS  Google Scholar 

  7. Goldstein JL, Kita T, Brown MS: Defective lipoprotein receptors and atherosclerosis. N Engl J Med 309: 288–296, 1983.

    Article  PubMed  CAS  Google Scholar 

  8. Havel RJ: Biology of cholesterol, lipoproteins and atherosclerosis. Clin Exp Hypertens 11: 887–900, 1989.

    CAS  Google Scholar 

  9. He J, Kryger MH, Zorik FJ, et al.: Mortality and apnea index in obstructive sleep apnea. Chest 94: 9–14, 1988.

    PubMed  CAS  Google Scholar 

  10. Howard BV, Schneiderman N, Falkner B, et al.: Insulin, health behaviors, and lipid metabolism. Metabolism 42: Suppl. 1: 25–35, 1993.

    Article  PubMed  CAS  Google Scholar 

  11. Hung J, Whitford EG, Parsons RW, et al. Association of sleep sapnoea with myocardial infarction in men. Lancet 336: 261–264, 1990.

    Article  PubMed  CAS  Google Scholar 

  12. Jenkinson C, Davies RJO, Mullins R, et al.: Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomized prospective parallel trial. Lancet 353: 2100–2105, 1999.

    Article  PubMed  CAS  Google Scholar 

  13. Lavie P, Herer P, Peled R, et al.: Mortality in sleep apnea patients: a multivariate analysis of risk factors. Sleep 18: 149–157 1995.

    PubMed  CAS  Google Scholar 

  14. Levine GN, Keaney JF, Vita LA: Cholesterol reduction in cardiovascular disease. N Engl J Med 332: 512–521, 1995.

    Article  PubMed  CAS  Google Scholar 

  15. Mayer J, Becker H, Brandenburg U, et al.: Blood pressure and sleep apnea: results of long-term nasal continuous positive airway pressure therapy. Cardiology 79: 84–92, 1991.

    Article  PubMed  CAS  Google Scholar 

  16. Partinen M, Jamieson A, Guilleminault C: Long-term outcome for obstructive sleep apnea syndrome patients. Chest 94: 1200–1204, 1988.

    PubMed  CAS  Google Scholar 

  17. Rechtschaffen A, Kales A: A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Washington, DC, U.S. Government Printing Office, 1968 (NIH publication No. 204).

    Google Scholar 

  18. Sniderman AD, Zhang XI, Cianflone K: Governance of the concentration of plasma LDL: a reevaluation of the LDL receptor paradigm. Atherosclerosis 148: 215–229, 2000.

    Article  PubMed  CAS  Google Scholar 

  19. Somers VK, Dyken ME, Clary MP et al.: Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 96: 1897–1904, 1995.

    Article  PubMed  CAS  Google Scholar 

  20. Suzuki M, Otsuka K, Guilleminault C: Long-term nasal continuous positive airway pressure administration can normalize hypertension in obstructive sleep apnea patients. Sleep 16: 545–549, 1993.

    PubMed  CAS  Google Scholar 

  21. Tang JL, Armitage JM, Lancaster T, et al.: Systematic review of dietary intervention trials to lower blood total cholesterol in free-living subjects. BMJ 316: 1213–1220, 1998.

    PubMed  CAS  Google Scholar 

  22. The Scandinavian Sim vastatin Survival Study Group: Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandmavian Simvastatin Survival Study (4S). Lancet 344: 1383–1389, 1994.

    Google Scholar 

  23. Tremblay A, Buemann B: Exercise-training, macronutrient balance and body weight control. Int J Obes Relat Metab Disord 19: 79–86, 1995.

    PubMed  CAS  Google Scholar 

  24. Wright J, Johns R, Watt I, et al.: Health effects of obstructive sleep apnoea and the effectiveness of continuous positive airways pressure: a systematic review of the research evidence. BMJ 314: 851–860, 1997.

    PubMed  CAS  Google Scholar 

  25. Young T, Palta M, Dempsey J, et al.: The occurrence of sleepdisordered breathing among middle-aged adults. New Engl J Med 328: 1230–1235, 1993.

    Article  PubMed  CAS  Google Scholar 

  26. Young T, Peppard P, Palta M, et al.: Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med 157: 1746–1752, 1997.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine I, Ruhr University Bochum, Marienhospital, Hoelkeskampring 40, D-44625, Herne, Germany

    Nikolaus J. Buechner, Walter Zidek, Martina Eßer, Michael Haske &  Bernd M. Sanner

Authors
  1. Nikolaus J. Buechner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Walter Zidek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martina Eßer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Haske
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bernd M. Sanner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bernd M. Sanner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Buechner, N.J., Zidek, W., Eßer, M. et al. Obstructive sleep apnea syndrome. Effects of therapy on dyslipidemia. Somnologie 5, 97–102 (2001). https://doi.org/10.1046/j.1439-054X.2001.01159.x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1046/j.1439-054X.2001.01159.x

Keywords

Search

Navigation