Effect of mild hyperglycemia on autonomic function in obstructive sleep apnea

Amanda C. Peltier, Kanika Bagai, Kay Artibee, André Diedrich, Emily Garland, Thomas Elasy, Yaping Shi, Lily Wang, Eva L. Feldman, David Robertson, Beth A. Malow

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Introduction: Obstructive sleep apnea (OSA) has been hypothesized to cause a hypersympathetic state, which may be the mechanism for the increased incidence of cardiovascular disease in OSA. However, there is a high prevalence of hyperglycemia in OSA patients, which may also contribute to autonomic dysfunction. Methods: Thirty-five patients with OSA and 11 controls with average body mass index (BMI) of 32.0 ± 4.6 underwent polysomnography, glucose tolerance testing, autonomic function tests, lying and standing catecholamines, overnight urine collection, and baseline ECG and continuous blood pressure measurements for spectral analysis. A linear regression model adjusting for age and BMI was used to analyze spectral data, other outcome measures were analyzed with Kruskal-Wallis test. Results: Twenty-three OSA patients and two control patients had hyperglycemia (based on 2001 American Diabetes Association criteria). Apnea-hypopnea index (AHI) correlated with total power and low frequency (LF) power (r = 0.138, 0.177, p = 0.031; and r = 0.013) but not with the LF/high frequency (HF) ratio (p = 0.589). Glucose negatively correlated with LF systolic power (r = -0.171, p = 0.038) but not AHI (p = 0.586) and was marginally associated with pnn50, total power, LF, and HF power (p ranged from 0.07 to 0.08). Conclusion: These data suggest that patients with OSA and mild hyperglycemia have a trend towards lower heart rate variability and sympathetic tone. Hyperglycemia is an important confounder and should be evaluated in studies of OSA and autonomic function.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalClinical Autonomic Research
Issue number1
StatePublished - Feb 2012
Externally publishedYes


  • Autonomic nervous system
  • Hyperglycemia
  • Sleep apnea obstructive

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology


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