Endocrine and Metabolic Aspects of OSA.

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2013-07
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Obstructive sleep apnea (OSA) is characterized by repeated spells of apnea. Collapsibility of hypopharynx due to multiple factors involving pharyngeal dilator muscles and deposition of fat or fluid in the surrounding soft tissues are important contributing factors in its pathogenesis. OSA commonly affects obese individuals. Males are more commonly affected than the females probably due to the disturbing effect of testosterone on sleep. The impact of OSA on human health include disturbances in endocrine and metabolic system affecting hypothalamic-pituitary-gonadal axis, adrenocorticotrophic-cortisol axis, growth hormone, antidiuretic hormones and insulin resistance. There is a tendency for predisposition of the metabolic syndrome or its components including glycemic dysregulation, hypertension, hyperlipidemia and physical parameters related to adiposity. On the other hand, several endocrine disorders such as hypothyroidism, growth hormone excess, polycystic ovarian disease and testosterone replacement are associated with increased prevalence of OSA. There is limited information on the effect of treatment of OSA by continuous positive airway pressure (CPAP) on the endocrine and metabolic disturbances. There is a need to conduct randomized controlled trials using CPAP therapy in patients with OSA and to study its cause and effect relationship with endocrine and metabolic disturbances.
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Goswami Ravinder. Endocrine and Metabolic Aspects of OSA. Annals of the National Academy of Medical Sciences (India). 2013 Jul-Dec; 49(3&4): 122-131.