Sleep and Metabolism in Obesity: Impact of Gender

肥胖是阻塞性睡眠呼吸暂停(OSA)的主要危险因素，OSA的特征是反复发作 呼吸紊乱，间歇性低氧，频繁的微唤醒和低睡眠 深度慢波睡眠的数量[SWS])。今天，有1000多万美国女性患有阻塞性睡眠呼吸暂停综合症。 OSA已被确定为代谢综合征的独立危险因素。因为OSA不仅仅是 OSA在男性中比在女性中流行，对OSA及其后果的研究数量不成比例 是在男性身上进行的。因此，阻塞性睡眠呼吸暂停综合症被描述为一种与性别相关的障碍 医疗保健不公平。最近的证据，包括我们小组的数据表明，减少的数量和 SWS的强度(即慢波活动[SWA])可能在新陈代谢和糖尿病的发生发展中发挥关键作用。 肥胖男性和女性的心血管疾病，特别是阻塞性睡眠呼吸暂停综合症患者。本项目将 SWA的性别差异及其与日间嗜睡和代谢易感性的关系 患有和不患有阻塞性睡眠呼吸暂停综合征的肥胖男性和女性。我们建议同时刻画：1.睡眠-觉醒 监管；2.糖尿病风险的衡量；3.心血管风险的衡量；4.性类固醇的概况， 非阻塞性睡眠呼吸暂停综合征肥胖男性治疗前后皮质醇和脂肪因子的变化 无阻塞性睡眠呼吸暂停的肥胖绝经前妇女，以及D. 肥胖绝经前阻塞性睡眠呼吸暂停综合征患者CPAP治疗前后的比较。这些项目的完成 跨学科研究将提供一个独特的数据集，将肥胖女性与肥胖男性进行对比 睡眠与代谢综合征、阻塞性睡眠呼吸暂停综合征的关系及其影响 持续正压通气治疗代谢综合征。拟议的工作将为以下方面提供重要的见解 阻塞性睡眠呼吸暂停的病理生理学及其对肥胖男性和女性的不良后果，以及 制定有效的针对性别的预防和治疗战略。

Obesity is a major risk factor for obstructive sleep apnea (OSA), a condition characterized by repetitive respiratory disturbances, intermittent hypoxia, sleep fragmentation by frequent microarousals and low amounts of deep slow wave sleep [SWS]). Today, more than 10 million American women suffer from OSA. OSA has been identified as an independent risk factor for the metabolic syndrome. Because OSA is more prevalent in men than in women, a disproportionate number of studies of OSA and its consequences have been conducted in men. Thus, OSA has been characterized as a disorder associated with gender-based health care inequity. Recent evidence, including data from our group, suggests that reduced amounts and intensity of SWS (i.e.slow-wave activity [SWA]) may play a pivotal role in the development of metabolic and cardiovascular disturbances in obese men and women, particularly those with OSA. The present project will focus on sex differences in SWA and their relationship with daytime sleepiness and metabolic vulnerability in obese men and women with and without OSA. We propose to simultaneously characterize: 1. sleep-wake regulation; 2. measures of diabetes risk 3. measures of cardiovascular risk and 4. profiles of sex steroids, cortisol and adipokines in a. obese men without OSA, b. obese men with OSA before and after treatment with continuous positive airway pressure (CPAP), c. obese pre-menopausal women without OSA, and d. obese pre-menopausal women with OSA before and after CPAP treatment. The completion of these interdisciplinary studies will provide a unique data set contrasting in obese women versus obese men the relationships between sleep and the metabolic syndrome, OSA and the metabolic syndrome and the impact of CPAP treatment on the metabolic syndrome. The proposed work will provide important insights regarding the pathophysiology of OSA and its adverse consequences in obese men and women, and the basis for the development of effective sex-specific prevention and treatment strategies.