• Jie-Feng Huang, Li-Da Chen, Qi-Chang Lin, Gong-Ping Chen, Yao-Hua Yu, Jian-Chai Huang, and Jian-Ming Zhao.
• Fujian Provincial Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
• Clin Respir J. 2016 Nov 1; 10 (6): 714-721.

BackgroundExcessive daytime sleepiness (EDS), which is commonly considered a cardinal sign of obstructive sleep apnea (OSA), may lead to an increased rate of metabolic syndrome (MetS), and be an independent risk factor for cardiovascular morbidity and mortality. The aim of this cross-sectional study was to examine the role of EDS in MetS and its components by researching severe OSA patients.MethodsThe records of 175 consecutive patients who underwent standard polysomnography and diagnosed severe OSA were included. Subjective daytime sleepiness was assessed using the Epworth sleepiness scale (ESS). Fasting glucose, lipids, insulin and polysomnography parameters were measured. A metabolic score was counted as the total number of the positive diagnostic criteria of MetS for each subject, which indicated the level of metabolic disorder.ResultsThe prevalence of central obesity, hypertriglyceridemia, low high density lipoprotein-cholesterol and MetS (78.2% vs 28.6%) was significantly higher among EDS group compared with control group. Compared with non-EDS patients, patients with EDS showed significantly higher metabolic score (3.22 ± 0.94 vs 1.96 ± 1.06). After adjustment for confounders, ESS score, log insulin and age significantly predicted the metabolic score (β = 0.567, P = 0.000; β = 0.197, P = 0.001 and β = 0.118, P = 0.048, respectively).ConclusionEDS was independently correlated with the sum of metabolic components in severe OSA patients. Our study suggested that EDS might be a potentially useful clinical marker to identify patients with severe OSA at risk of MetS.© 2015 John Wiley & Sons Ltd.

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