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SUN 50-71-HPA Axis
Expo Halls ABC (Moscone Center)
Poster Board SUN-67
BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep disorder with serious cardiovascular and metabolic co-morbidities that may be mediated by increased cortisol secretion [1,2]. Recent studies have examined the effect of continuous positive airway pressure (CPAP) on cortisol secretion in OSA patients, but the results have been mixed [3-7]. However, these studies used saliva and plasma to measure cortisol, thus only providing point measures of cortisol secretion. Hair cortisol analysis presents a means of non-invasively and retrospectively examining cortisol production over several months .
OBJECTIVES: To determine, in patients with OSA, the effect of CPAP on long-term cortisol exposure assessed by hair cortisol measurements..
DESIGN AND METHODS: Patients were recruited after OSA was diagnosed using a polysomnogram. Physical exam information and medical history were recorded. Polysomnogram data including the apnea-hypopnea index (AHI), total hypoxemic time, and arousals per hour were recorded before and after CPAP. Additionally, a hair sample and Perceived Stress Scale (PSS) were collected before and after CPAP. Hair cortisol concentrations were determined using our modified salivary cortisol ELISA protocol.
RESULTS: Ninety-two patients were enrolled in the study, of which 31 returned after 3 months of CPAP therapy. A trend towards increased hair cortisol concentrations was noted when comparing mild OSA patients with moderate and severe OSA patients (P=0.056). Hair cortisol concentrations were weakly negatively associated with total hypoxemic time (r2=0.06, P<0.05). CPAP treatment did not change hair cortisol concentrations, but perceived stress was reduced following placement on CPAP (P<0.001).
CONCLUSION: Cortisol secretion may be up-regulated in severe cases of OSA. While subjectively experienced stress may benefit from 3 months of CPAP treatment, physiological stress may remain.
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Nothing to Disclose: ER, GK, MR, SV, KKC, CG, BR
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