Endocrine and Metabolic Aspects of OSA


  • Ravinder Goswami


Obstructive sleep apnea (OSA) is characterized by repeated spells of apnea.
Collapsibility of hypopharynx due to multiple factors involving pharyngeal dilator
muscles and deposition of fat or fluid in the surrounding soft tissues are important
contributing factors in its pathogenesis. OSA commonly affects obese individuals.
Males are more commonly affected than the females probably due to the disturbing
effect of testosterone on sleep.
The impact of OSA on human health include disturbances in endocrine and metabolic
system affecting hypothalamic-pituitary-gonadal axis, adrenocorticotrophic-cortisol
axis, growth hormone, antidiuretic hormones and insulin resistance. There is a
tendency for predisposition of the metabolic syndrome or its components including
glycemic dysregulation, hypertension, hyperlipidemia and physical parameters related
to adiposity. On the other hand, several endocrine disorders such as hypothyroidism,
growth hormone excess, polycystic ovarian disease and testosterone replacement are
associated with increased prevalence of OSA.
There is limited information on the effect of treatment of OSA by continuous positive
airway pressure (CPAP) on the endocrine and metabolic disturbances. There is a need
to conduct randomized controlled trials using CPAP therapy in patients with OSA and
to study its cause and effect relationship with endocrine and metabolic disturbances.