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. 2020 Apr 15;16(4):475-482.
doi: 10.5664/jcsm.8242.

Association between obstructive sleep apnea and lipid metabolism during REM and NREM sleep

Huajun Xu  1   2   3   4 , Yunyan Xia  1   2   3   5   4 , Xinyi Li  1   2   3 , Yingjun Qian  1   2   3 , Jianyin Zou  1   2   3 , Fang Fang  6 , Hongliang Yi  1   2   3 , Hongmin Wu  1   2 , Jian Guan  1   2   3 , Shankai Yin  1   2   3
Affiliations

Association between obstructive sleep apnea and lipid metabolism during REM and NREM sleep

Huajun Xu et al. J Clin Sleep Med. .

Abstract

Study objectives: Obstructive sleep apnea (OSA) is thought to be associated with dyslipidemia. However, differences concerning dyslipidemia during rapid eye movement (REM) and non-REM (NREM) sleep have yet to be determined. This study was designed to explore the association between lipid profiles and OSA during REM or NREM sleep.

Methods: This is a clinical cohort. A total of 2,619 participants with at least 30 minutes of REM sleep were included. Sleep variables and fasting lipid profiles [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein (apo)A-I, apoB, apoE, and lipoprotein(a) (Lp(a))] were obtained from each participant. Apnea-hypopnea indices in REM and NREM sleep (AHIREM and AHINREM, respectively) were recorded. Linear regression analysis was used to assess the associations of AHIREM and AHINREM with lipid profiles.

Results: When stratified by the AHIREM severity of OSA, all demographics, clinical variables, and sleep parameters differed between the groups except for apoA-I. In fully-adjusted multivariate linear regression models, AHIREM was independently associated with increasing levels of TG, HDL-C, and apoE (P = .04, P = .01 and P = .01, respectively). AHINREM was independently associated with increasing levels of TC, TG, LDL, and apoB, and lower level of HDL-C (all P < .05). In sensitivity analyses by only exploring associations in patients who had an AHINREM or AHIREM < 5 events/h in separate regression models, AHIREM was not associated with all-lipid profile in almost all adjusted models (all P > .05), whereas AHINREM was associated with elevated TC, LDL-C, and apoB (P = .03, P = .01 and P = .01, respectively).

Conclusions: AHINREM was independently associated with the greatest alterations in serum lipids, including TC, LDL-C, and apoB.

Keywords: dyslipidemia; lipid profile; obstructive sleep apnea; rapid eye movement.

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