Clinical Research Papers:

Excessive daytime sleepiness and metabolic syndrome in men with obstructive sleep apnea: a large cross-sectional study

Yiqun Fu, Huajun Xu, Yunyan Xia, Yingjun Qian, Xinyi Li, Jianyin Zou, Yuyu Wang, Lili Meng, Xulan Tang, Huaming Zhu, Huiqun Zhou, Kaiming Su, Dongzhen Yu, Hongliang Yi, Jian Guan _ and Shankai Yin

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Oncotarget. 2017; 8:79693-79702. https://doi.org/10.18632/oncotarget.19113

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Yiqun Fu1,2,3,*, Huajun Xu1,2,3,*, Yunyan Xia1,2,3,*, Yingjun Qian1,2,3, Xinyi Li1,2,3, Jianyin Zou1,2,3, Yuyu Wang1,2,3, Lili Meng1,2, Xulan Tang1,2, Huaming Zhu1,2, Huiqun Zhou1,2, Kaiming Su1,2, Dongzhen Yu1,2, Hongliang Yi1,2, Jian Guan1,2 and Shankai Yin1,2

1 Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

2 Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China

3 Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

* These authors have contributed equally to this paper

Correspondence to:

Jian Guan, email:

Hongliang Yi, email:

Shankai Yin, email:

Keywords: excessive daytime sleepiness, metabolic syndrome, obesity, obstructive sleep apnea

Received: October 29, 2016 Accepted: June 18, 2017 Published: July 08, 2017


Purpose: Excessive daytime sleepiness is a common symptom in obstructive sleep apnea (OSA). Previous studies have showed that excessive daytime sleepiness is associated with some individual components of metabolic syndrome. We performed a large cross-sectional study to explore the relationship between excessive daytime sleepiness and metabolic syndrome in male OSA patients.

Methods: A total of 2241 suspected male OSA patients were consecutively recruited from 2007 to 2013. Subjective daytime sleepiness was assessed using the Epworth sleepiness scale. Anthropometric, metabolic, and polysomnographic parameters were measured. Metabolic score was used to evaluate the severity of metabolic syndrome.

Results: Among the male OSA patients, most metabolic parameters varied by excessive daytime sleepiness. In the severe group, male OSA patients with excessive daytime sleepiness were more obese, with higher blood pressure, more severe insulin resistance and dyslipidemia than non-sleepy patients. Patients with metabolic syndrome also had a higher prevalence of excessive daytime sleepiness and scored higher on the Epworth sleepiness scale. Excessive daytime sleepiness was independently associated with an increased risk of metabolic syndrome (odds ratio =1.242, 95% confidence interval: 1.019-1.512). No substantial interaction was observed between excessive daytime sleepiness and OSA/ obesity.

Conclusions: Excessive daytime sleepiness was related to metabolic disorders and independently associated with an increased risk of metabolic syndrome in men with OSA. Excessive daytime sleepiness should be taken into consideration for OSA patients, as it may be a simple and useful clinical indicator for evaluating the risk of metabolic syndrome.

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