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Polycystic Ovary Syndrome and Sleep Disorders: Association Between Metabolic and Androgenic Alterations with Sleep Components

Yıl 2022, Cilt: 17 Sayı: 2, 67 - 72, 15.07.2022
https://doi.org/10.17517/ksutfd.894115

Öz

Objective: To investigate the sleep quality in patients with polycystic ovary syndrome (PCOS) and to examine the effects of metabolic parameters on sleep disturbances.
Material and Methods: The study included 50 patients diagnosed as PCOS and 51 normal healthy volunteers. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality. Index consists of 18 items and seven components and according to the index, the total scores of five or more indicate a poor sleep quality. After the sleep quality scores were determined, serum insulin, triglyceride, cholesterol, fasting glucose and androgen levels were recorded retrospectively and all parameters compared between groups.
Results: The sleep quality was lower in the patients with polycystic ovary syndrome than in the healthy control group but this was not statistically significant (p>0.05). Serum dehydroepiandrosterone sulfate (DHESO4) and total testosterone level had a significant negative correlation with sleep duration and total
PSQI scores. In addition, serum total testosterone level also had a significant negative correlation with sleep latency, sleep disturbance and subjective sleep quality. Besides, the patients with the poor sleep quality had significantly lower serum dehydroepiandrosterone sulfate and testosterone levels than those with a normal sleep quality (p<0.05).
Conclusion: Androgenic alterations in polycystic ovary syndrome may have a negative effect on their sleep components. It should be kept in mind during routine follow-ups of these patients that they can have sleep disturbances as well as metabolic and androgenic disorder.

Kaynakça

  • Asuncion M, Calvo RM, San Millan JL, Sancho J, Avila S, Escobar- Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab 2000;85:2434–2438.
  • Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS, Legro RS. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr Rev 2015;36(5):487–525.
  • Wang R, Mol BW. The Rotterdam criteria for polycystic ovary syndrome: evidence-based criteria? Hum Reprod 2017 Feb;32(2):261-264.
  • Helvaci N, Karabulut E, Demir AU, Yildiz BO. Polycystic ovary syndrome and the risk of obstructive sleep apnea: a meta-analysis and review of the literature. Endocr Connect. 2017;6:437- 445.
  • De Sousa G, Schluter B, Buschatz D, Menke T, Trowitzsch E, Andler W et al. A comparison of polysomnographic variables between obese adolescents with polycystic ovarian syndrome and healthy, normal-weight and obese adolescents. Sleep Breath 2010;14:33-38.
  • Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R et al. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2013;98:4565-4592.
  • March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010;25(2):544–551.
  • Moran LJ, March WA, Whitrow MJ, Giles LC, Davies MJ, Moore VM. Sleep disturbances in a community-based sample of women with polycystic ovary syn- drome. Hum Reprod 2015;30:466-472.
  • Thannickal A, Brutocao C, Alsawas M, Morrow A, Zaiem F, Murad MH et al. Eating, Sleeping and Sexual Function Disorders in Women with Polycystic Ovary Syndrome (PCOS): a systematic review and meta-analysis. Clin Endocrinol (Oxf) 2020 Apr;92(4):338-349
  • Simon S, Rahat H, Carreau AM, Garcia-Reyes Y, Halbower A, Pyle L, et al. Poor Sleep is Related to Metabolic Syndrome Severity in Adolescents with PCOS and Obesity. J Clin Endocrinol Metab 2020 Apr 1;105(4): 1827-1834.
  • Sam S, Ehrmann DA. Pathogenesis and Consequences of Disordered Sleep in PCOS. Clin Med Insights Reprod Health 2019 Sep 3;13:1179558119871269.
  • Tasali E, Van Cauter E, Ehrmann DA. Relationships between sleep disordered breathing and glucose metabolism in polycystic ovary syndrome. J Clin Endocrinol Metab 2006;91:36-42.
  • McCartney CR, Marshall JC. Clinical practice. Polycystic ovary syndrome. N Engl J Med 2016;375:54-64.
  • Fogel RB, Malhotra A, Pillar G, Pittman SD, Dunaif A, White DP. Increased prevalence of obstructive sleep apnea syndrome in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 2001;86:1175-1180.
  • Vgontzas AN, Legro RS, Bixler EO, Grayev A, Kales A, Chrousos GP. Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab 2001;86:517-520.
  • Yang HP, Kang JH, Su HY, Tzeng CR, Liu WM, Huang SY. Apnea-Hypopnea Index in non obese women with polycystic ovary syndrome. Int J Gynaecol Obstet 2009;105:226-229.
  • Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
  • Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81(1):19–25.
  • Jellinger PS, Handelsman Y, Rosenblit PD, Bloomgarden ZT, Fonseca VA, Garber AJ et al. American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocr Pract. 2017 Apr;23(Suppl 2):1-87.
  • Chatterjee B, Suri J, Suri JC, Mittal P, Adhikari T. Impact of sleep-disordered breathing on metabolic alterations in patients with polycystic ovary syndrome. Sleep Med 2014;15:1547-1553.
  • Nandalike K, Strauss T, Agarwal C, Coupey SM, Sin S, Rajpathak S, et al. Screening for sleep-disordered breathing and excessive daytime sleepiness in adolescent girls with polycystic ovarian syndrome. J Pediatr 2011;159:591-596.
  • Samuel VT, Shulman GI. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. J Clin Invest 2016;126(1):12–22.
  • Anderson B, Marin P, Lissner L, Vermeulen A, Bjorntorp P. Testosterone concentrations in women and men with NIDDM. Diabetes Care 1994 May;17(5):405-411.
  • De Sousa G, Schluter B, Buschatz D, Menke T, Trowitzsch E, Andler W et al. The impact of insulin resistance and hyperandrogenemia on polysomnographic variables in obese adolescents with polycystic ovarian syndrome. Sleep Breath. 2012;16:169- 175.
  • Jamilian M , Foroozanfard F, Mirhosseini N , Kavossian E, Aghadavod E , Bahmani F et al. Effects of Melatonin Supplementation on Hormonal, Inflammatory, Genetic, and Oxidative Stress Parameters in Women With Polycystic Ovary Syndrome. Front Endocrinol (Lausanne). 2019 May 14;10:273.

Polikistik Over Sendromu ve Uyku Bozuklukları: Uyku Bileşenleri ile Metabolik ve Androjenik Bozukluklar Arasındaki İlişki

Yıl 2022, Cilt: 17 Sayı: 2, 67 - 72, 15.07.2022
https://doi.org/10.17517/ksutfd.894115

Öz

Amaç: Polikistik over sendromlu (PKOS) hastalarda uyku kalitesinin araştırılması ve metabolik parametrelerin uyku bozuklukları üzerine etkilerini incelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Çalışmaya PKOS tanısı alan 50 hasta ve 51 normal sağlıklı gönüllü dahil edildi. Uyku kalitesini değerlendirmek için Pittsburgh Uyku Kalitesi İndeksi (PSQİ) kullanıldı. İndeks, 18 madde ve yedi bileşenden oluşmaktadır ve endekse göre alınan beş veya daha fazla toplam puan, kötü uyku kalitesini
göstermektedir. Uyku kalitesi skorları belirlendikten sonra serum insülin, trigliserit, kolesterol, açlık glikoz ve androjen seviyeleri geriye dönük olarak kaydedildi ve tüm parametreler gruplar arasında karşılaştırıldı.
Bulgular: PKOS’lu hastalarda uyku kalitesi, sağlıklı kontrol grubuna göre daha düşüktü fakat istatistiksel olarak anlamlı değildi (p>0.05). Serum Dihidroepiandrosteron sülfat (DHESO4) ve total testosteron düzeyi ile uyku süresi ve toplam PSQİ skorları arasında anlamlı negatif korelasyon vardı. Ek olarak serum
total testosteron düzeyi ile de uyku gecikmesi, uyku bozuklukları ve öznel uyku kalitesi arasında anlamlı negatif korelasyon saptandı. Ayrıca uyku kalitesi düşük olan hastaların serum DHESO4 ve testosteron düzeyleri normal uyku kalitesine sahip olanlara göre anlamlı olarak daha düşüktü (p<0.05).
Sonuç: Polikistik over sendromundaki androjenik değişiklikler uyku komponentlerini olumsuz yönde etkileyebilir. Bu hastaların rutin takiplerinde metabolik ve androjenik bozuklukların yanı sıra uyku bozuklukları da olabileceği akılda tutulmalıdır.

Kaynakça

  • Asuncion M, Calvo RM, San Millan JL, Sancho J, Avila S, Escobar- Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab 2000;85:2434–2438.
  • Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS, Legro RS. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr Rev 2015;36(5):487–525.
  • Wang R, Mol BW. The Rotterdam criteria for polycystic ovary syndrome: evidence-based criteria? Hum Reprod 2017 Feb;32(2):261-264.
  • Helvaci N, Karabulut E, Demir AU, Yildiz BO. Polycystic ovary syndrome and the risk of obstructive sleep apnea: a meta-analysis and review of the literature. Endocr Connect. 2017;6:437- 445.
  • De Sousa G, Schluter B, Buschatz D, Menke T, Trowitzsch E, Andler W et al. A comparison of polysomnographic variables between obese adolescents with polycystic ovarian syndrome and healthy, normal-weight and obese adolescents. Sleep Breath 2010;14:33-38.
  • Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R et al. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2013;98:4565-4592.
  • March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010;25(2):544–551.
  • Moran LJ, March WA, Whitrow MJ, Giles LC, Davies MJ, Moore VM. Sleep disturbances in a community-based sample of women with polycystic ovary syn- drome. Hum Reprod 2015;30:466-472.
  • Thannickal A, Brutocao C, Alsawas M, Morrow A, Zaiem F, Murad MH et al. Eating, Sleeping and Sexual Function Disorders in Women with Polycystic Ovary Syndrome (PCOS): a systematic review and meta-analysis. Clin Endocrinol (Oxf) 2020 Apr;92(4):338-349
  • Simon S, Rahat H, Carreau AM, Garcia-Reyes Y, Halbower A, Pyle L, et al. Poor Sleep is Related to Metabolic Syndrome Severity in Adolescents with PCOS and Obesity. J Clin Endocrinol Metab 2020 Apr 1;105(4): 1827-1834.
  • Sam S, Ehrmann DA. Pathogenesis and Consequences of Disordered Sleep in PCOS. Clin Med Insights Reprod Health 2019 Sep 3;13:1179558119871269.
  • Tasali E, Van Cauter E, Ehrmann DA. Relationships between sleep disordered breathing and glucose metabolism in polycystic ovary syndrome. J Clin Endocrinol Metab 2006;91:36-42.
  • McCartney CR, Marshall JC. Clinical practice. Polycystic ovary syndrome. N Engl J Med 2016;375:54-64.
  • Fogel RB, Malhotra A, Pillar G, Pittman SD, Dunaif A, White DP. Increased prevalence of obstructive sleep apnea syndrome in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 2001;86:1175-1180.
  • Vgontzas AN, Legro RS, Bixler EO, Grayev A, Kales A, Chrousos GP. Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab 2001;86:517-520.
  • Yang HP, Kang JH, Su HY, Tzeng CR, Liu WM, Huang SY. Apnea-Hypopnea Index in non obese women with polycystic ovary syndrome. Int J Gynaecol Obstet 2009;105:226-229.
  • Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
  • Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81(1):19–25.
  • Jellinger PS, Handelsman Y, Rosenblit PD, Bloomgarden ZT, Fonseca VA, Garber AJ et al. American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocr Pract. 2017 Apr;23(Suppl 2):1-87.
  • Chatterjee B, Suri J, Suri JC, Mittal P, Adhikari T. Impact of sleep-disordered breathing on metabolic alterations in patients with polycystic ovary syndrome. Sleep Med 2014;15:1547-1553.
  • Nandalike K, Strauss T, Agarwal C, Coupey SM, Sin S, Rajpathak S, et al. Screening for sleep-disordered breathing and excessive daytime sleepiness in adolescent girls with polycystic ovarian syndrome. J Pediatr 2011;159:591-596.
  • Samuel VT, Shulman GI. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. J Clin Invest 2016;126(1):12–22.
  • Anderson B, Marin P, Lissner L, Vermeulen A, Bjorntorp P. Testosterone concentrations in women and men with NIDDM. Diabetes Care 1994 May;17(5):405-411.
  • De Sousa G, Schluter B, Buschatz D, Menke T, Trowitzsch E, Andler W et al. The impact of insulin resistance and hyperandrogenemia on polysomnographic variables in obese adolescents with polycystic ovarian syndrome. Sleep Breath. 2012;16:169- 175.
  • Jamilian M , Foroozanfard F, Mirhosseini N , Kavossian E, Aghadavod E , Bahmani F et al. Effects of Melatonin Supplementation on Hormonal, Inflammatory, Genetic, and Oxidative Stress Parameters in Women With Polycystic Ovary Syndrome. Front Endocrinol (Lausanne). 2019 May 14;10:273.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Özgür Deniz Turan 0000-0003-2230-8404

Erken Görünüm Tarihi 11 Temmuz 2022
Yayımlanma Tarihi 15 Temmuz 2022
Gönderilme Tarihi 10 Mart 2021
Kabul Tarihi 18 Mayıs 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 17 Sayı: 2

Kaynak Göster

AMA Turan ÖD. Polycystic Ovary Syndrome and Sleep Disorders: Association Between Metabolic and Androgenic Alterations with Sleep Components. KSÜ Tıp Fak Der. Temmuz 2022;17(2):67-72. doi:10.17517/ksutfd.894115