AUTHOR=Pham Luu V. , Schwartz Alan R. , Jun Jonathan C. TITLE=Oxyhemoglobin Saturation Overshoot Following Obstructive Breathing Events Mitigates Sleep Apnea-Induced Glucose Elevations JOURNAL=Frontiers in Endocrinology VOLUME=9 YEAR=2018 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2018.00477 DOI=10.3389/fendo.2018.00477 ISSN=1664-2392 ABSTRACT=

Background: Obstructive sleep apnea (OSA) and nocturnal hypoxia are associated with disturbances in glucose regulation and diabetes. Temporal associations between OSA, oxygenation profiles and glucose have not been well-described. We hypothesized that oxyhemoglobin desaturation during apneic events and subsequent post-apnea saturation overshoot predict nocturnal glucose.

Methods: In 30 OSA patients who underwent polysomnography while subjected to CPAP withdrawal, we characterized S_PO₂ swings by frequency, desaturation depth, and overshoot height relative to baseline. We examined the associations between frequently sampled glucose and S_PO₂ swings during the preceding 10 min. We developed multi-variable mixed effects linear regression to examine the independent associations between glucose and each level of these S_PO₂ swings, while controlling for OSA severity.

Results: Desaturation depth was not associated with glucose (p > 0.05). In contrast, overshoot was associated with glucose in a dose-dependent manner. Each S_PO₂ peak that did not rise to within 1% of baseline was associated with incremental glucose elevations of 0.49 mg/dL (p = 0.01), whereas peaks that exceeded baseline by >1% were associated with glucose reductions of 0.46 mg/dL. Overshoot remained an independent predictor of glucose after adjustment for mean S_PO₂ and OSA severity (p > 0.05).

Conclusions: Vigorous S_PO₂ improvements after apneic events may protect patients against OSA-related glucose elevations.