Effects of polycystic ovary syndrome (PCOS) on REM and non-REM sleep in African-American (AA) women

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 532-553-Hyperandrogenic Disorders
Basic/Clinical
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-543
Lisa L Morselli*1, Karla A Temple1, Babak Mokhlesi1, Esra Tasali2, Florian Chapotot1, Eve Van Cauter1 and David A Ehrmann1
1University of Chicago, Chicago, IL, 2The University of Chicago, Chicago, IL
Poor sleep quality and obstructive sleep apnea (OSA) are common among women with PCOS, particularly AA women. Mood disorders (e.g., depression) are also associated with both PCOS and sleep disturbances, particularly in REM sleep. Disruption of stage N3 of non-REM (NREM) sleep, also known as slow wave sleep (SWS), suppresses both insulin secretion and action and could be involved in the metabolic alterations of PCOS.  OSA is generally associated with lower amounts of SWS, but studies have been mostly performed in men.  The aim of the present study was to examine the effects of PCOS on sleep architecture in AA women and controls.

Overnight polysomnography was performed in 21 AA PCOS women (28 ± 1 yr, BMI 38 ± 2 kg/m2) and 21 AA controls matched for age (29 ± 1 yrs), BMI (39 ± 2 kg/m2), and OSA presence and severity. None of the participants were using hypnotics or other medications with a potential to alter sleep. Sleep recordings were visually scored in stages wake, N1, N2, N3 and REM using standard criteria. The presence of OSA was defined by an apnea-hypopnea index (AHI) > 5 events/h. Spectral analysis was used to quantify the intensity of non-REM sleep (delta  activity: absolute spectral power in the 0.75 - 4 Hz band). Results are reported as mean ± SEM.

As expected, testosterone and free testosterone levels were higher in PCOS patients. One third of both control and PCOS subjects had OSA, and AHI was similar in both groups (PCOS 7 ± 1, vs controls 6 ± 2; p=0.13). No significant differences in sleep stage duration were observed between groups over the entire night. However, PCOS patients had more REM sleep than controls in the first 3 hours of sleep (26 ± 3 vs 18 ± 2 min; p=0.04). No group differences were detected in delta activity in NREM sleep.

In conclusion, African-American women with PCOS appear to have an increased REM sleep duration in the first hours of sleep. REM sleep is normally prevalent in the second half of the night. Abnormal REM sleep distribution is one of the hallmarks of sleep abnormalities observed in depression and may be related to the higher risk of mood disorders in PCOS patients.  Disorders of SWS do not appear to contribute to the metabolic alterations in women with PCOS.

Nothing to Disclose: LLM, KAT, BM, ET, FC, EV, DAE

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm