ABSTRACT The prevalence of obstructive sleep apnea syndrome (OSAS) is clearly increased in adults with polycystic ovarian syndrome (PCOS). The symptoms of PCOS usually begin around menarche. However, data concerning poly¬somnographic variables in adolescents with PCOS are limited. As obesity is a well-known risk factor for OSAS, we aimed to analyze differences in polysomnographic variables between obese and extremely obese adolescents with PCOS and healthy, normal-weight, obese, and extremely obese controls. Methods: Sixteen obese and 17 extremely obese adolescents with PCOS, 18 normal-weight, 17 obese, and 13 extremely obese controls underwent polysomno¬graphy to compare mean transcutaneous arterial oxygen saturation (Sat O2), apnea-index (AI), hypopnea- index (HI), apnea-hypopnea index (AHI), the absolute number of obstructive apneas (NOA), percentage sleep stages 3 and 4 of non REM-sleep (stages 3 & 4), percentage of REM-sleep (% REM), sleep-onset latency, and sleep efficiency. Results: We found no significant differences between the groups concerning AI, HI, AHI, NOA, and stages 3 & 4. Significant differ¬ences between the groups were found regarding Sat O2, % REM, sleep-onset latency, and sleep efficiency. Conclusions: Concerning the respiratory variables, adolescents with PCOS do not seem to differ from healthy controls regardless of weight status, but there seem to be differences in sleep architecture.
Cite this paper
nullG. Sousa, B. Schlüter, T. Menke, E. Trowitzsch, W. Andler and T. Reinehr, "A Comparison of Polysomnographic Variables between Adolescents with Polycystic Ovarian Syndrome and Healthy Controls," International Journal of Clinical Medicine, Vol. 1 No. 2, 2010, pp. 48-53. doi: 10.4236/ijcm.2010.12009.
 E. S. Knochenhauer, T. J. Key, M. Kahsar-Miller, W. Waggoner, “Boots LR, Azziz R. Prevalence of the Poly-cystic Ovary Syndrome in Unselected Black and White Women of the Southeastern United States: a Prospective Study,” Journal of Clinical Endocrinology ＆ Metabolis, Vol. 83, 1998, pp. 3082-3098.
J. K. Zawadski and A. Dunaif, “Diagnostic Criteria for Polycystic Ovary Syndrome: Towards a Rational Ap?proach,” In: A. Dunaif, J. R. Givens, F. P. Haseltine and G. R. Merriam, Ed., Polycystic Ovary Syndrome. Boston: Blackwell Scientific Publications, 1992, PP.377-384.
S. Sam and A. Dunaif, “Polycystic Ovary Syndrome: Syndrome XX?” Trends in Endocrinology and Metabo?lism, Vol. 14, 2003, pp. 365-370.
D. A. Ehrmann, “Polycystic Ovary Syndrome,” The New England Journal Medicine, Vol. 352, 2005, pp. 1223-1236.
R. B. Fogel, A. Malhotra, G. Pillar, S. D. Pittman, A. Dunaif and D. P. White, “Increased Prevalence of Ob?structive Sleep Apnea Syndrome in Obese Women with Polycystic Ovary Syndrome, Journal of Clinical Endocrinology ＆ Metabolis, Vol. 86, 2001, pp. 1175-1180.
A. N. Vgontzas, R. S. Legro, E. O. Bixler, A. Grayev, A. Kales and G. P. Chrousos, “Polycystic Ovary Syndrome Is Associated with Obstructive Sleep Apnea and Daytime Sleepiness: Role of Insulin Resistance,”. Journal of Clinical Endocrinology ＆ Metabolis, Vol. 86, 2001, pp. 517-520.
M. Gopal, S. Duntley, M. Uhles and H. Attarian, “The Role of Obesity in the Increased Prevalence of Obstruc?tive Sleep Apnea Syndrome in Patients with Polycystic Ovarian Syndrome,” Sleep Medicine, Vol. 3, 2002, pp. 401-404.
E. Tasali, E. Van Cauter, L. Hoffman and D. A. Ehrmann, “Impact of Obstructive Sleep Apnea on Insulin Resis-tance and Glucose Tolerance in Women with Polycystic Ovary Syndrome,” Journal of Clinical Endocrinology ＆Metabolis, Vol. 93, 2008, pp. 3878-3884.
E. Tasali, E. V. Cauter and D. A. Ehrmann, “Relationship between Sleep Disordered Breathing and Glucose Me?tabolism in Polycystic Ovary Syndrome,” Journal of Clinical Endocrinology ＆ Metabolis, Vol. 91, 2006, pp. 36-42.
S. Subramanian, A. Desai, M. Joshipura and S. Surani, “Practice Patterns of Screening for Sleep Apnea in Physi?cians Treating PCOS Patients,” Sleep and Breathing, Vol. 11, 2007, pp. 233-237.
H. K. Yaggi, J. Concato, W. N. Kernan, J. H. Lichtman, L. M. Brass and V. Mohsenin, “Obstructive Sleep Apnea as a Risk Factor for Stroke and Deat,” The New England Journal Medicine, Vol. 353, 2005, pp. 2034-2041.
G. D. Sousa, B. Schlüter, D. Buschatz, T. Menke, E. Trowitzsch, W. Andler and T. Reinehr, “A comparison of Polysomnographic Variables between Obese Adolescents with Polycystic Ovarian Syndrome and Healthy, nor?mal-weight and Obese Adolescents,” Sleep and Breathing, Vol. 14, 2010, pp. 33-38.
M. Kalra, T. Inge, V. Garcia, S. Daniels, L. Lawson, R. Curti, A. Cohen and R. Amin, “Obstructive sleep Apnea in Extremely Overweight Adolescents Undergoing Bari?atric Surgery,” Obesity Research, Vol. 13, 2005, pp. 1175-1179.
S. Redline, P. V. Tishler, M. Schluchter, J. Aylor, K. Clark and G. Graham, “Risk Factors for Sleep-disordered Breathing in Children Associations with Obesity, Race, and Respiratory Problems,” American Journal Respira?tory Critical Care Medicine, Vol. 159, 1999, pp. 1527-1532.
T. J. Cole, M. C. Belizzi, K. M. Flegal and W. H. Dietz, “Establishing a Standard Definition for Child Overweight and Obesity Worldwide: International Survey,” British Medical Journal, Vol. 320, 2000, pp. 1240-1243.
K. Kromeyer-Hauschild, M. Wabitsch, D. Kunze, F. Geller, C. Geib and V. Hesse, et al., “Percentiles of Body Mass Index in Children and Adolescents Evaluated from Different Regional German Studies,” Monatsschr Kin?derheilkd, Vol. 149, 2001, pp. 807-818.
T. J. Cole, “The LMS method for constructing normalized growth standards,” European Journal Clinical Nutrition, Vol. 44, 1990, pp. 45-60.
A. Rechtschaffen and A. Kales, “A Manual of Standard-ized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects,” Washington DC: U.S. Government Printing Office, Washington, 1968.
AASM “EEG arousals: scoring rules and examples,” A Preliminary Report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association,” Sleep, Vol. 15, 1992, pp. 174-184.
AASM, “Sleep-related Breathing Disorders in Adults: Recommendations for Syndrome Definition and Meas-urement Techniques in Clinical Research,” The Report of an American Academy of Sleep Medicine Task Force. Sleep, Vol. 22, 1999, pp. 667-689.
A. K Schr?der, S. Tauchert, O. Ortmann, K. Diedrich and J. M. Weiss, “Insulin Resistance in Polycystic Ovary Syndrome,” Wien Klin Wochenschr, Vol. 115, 2003, pp. 812-821.
A. K. Schr?der, S. Tauchert, O. Ortmann, K. Diedrich and J. M. Weiss, “Insulin Resistance in Patients with Polycystic Ovary Syndrome,” Annals of Internal Medicine, Vol. 36, 2004, pp. 426-439.
A. Galluzzo, M. C. Amato and C. Giordano, “Insulin Resistance and Polycystic Ovary Syndrome,” Nutrition Metabolism ＆ Cardiovasc Diseases, Vol. 18, 2008, pp. 511-518.
J. P. Després and I. Lemieux, “Abdominal Obesity and Metabolic Syndrome,” Nature, Vol. 444, 2006, pp. 881-887.
B. L. Wajchenberg, “Subcutaneous and Visceral Adipose tissue: Their Relation to the Metabolic Syndrome,” En?docrine Reviews, Vol. 21, 2000, pp. 697-738.
S. E. Kahn, R. L. Prigeon, R. S. Schwartz, W. Y. Fuji-moto, R. H. Knopp and J. D. Brunzell, et al., “Obesity, Body Fat Distribution, Insulin Sensitivity and Islet beta-cell Function as Explanations for Metabolic Diver?sity,” Journal Nutrition, Vol. 131, 2001, pp. 354-360.
P.Bj?rntorp, “Metabolic Implications of Body Fat Distri-bution,” Diabetes Care, Vol. 14, 1991, pp. 1132-1143.
H. Sch?fer, D. Pauleit, T. Sudhop, I. Gouni-Berthold, S. Ewig and H. K. Berthold, “Body Fat Distribution, Serum lepton, and Cardiovascular Risk Factors in Men with Obstructive Sleep Apnea,” Chest, Vol. 122, 2002, pp. 829-839.
E. Shinohara, S. Kihara, S. Yamashita, M. Yamane, M. Nishida and T. Arai, et al., “Visceral Fat Accumulation as an Important Risk Factor for Obstructive Sleep Apnoea Syndrome in Obese Dubjects,” Journal of Internal Medi?cine, Vol. 241, 1997, pp. 11-18.
L. Busetto and G. Sergi, “Visceral Fat and Respiratory complications,” Diabetes Obesity Metabolism, Vol. 1, 2005, pp. 301-306.
J. T. Moyle, “Uses and Abuses of Pulse Oximetry,” Ar-chives Disease Childhood, Vol. 74, 1996, pp. 77-80.
C. Maffeis, A. Pietrobelli, A. Grezzani, S. Provera and L.Tatò, “Waist Circumference and Cardiovascular Risk Factors in Prepubertal Children,” Obesity Research, Vol. 9, 2001, pp. 179-187.