0884 Slow Wave Sleep Is Associated with Glucose Metabolism in Obstructive Sleep Apnea: A Registry-based Study

Abstract Introduction Obstructive sleep apnea (OSA) is a common condition being increasingly recognized and is a known risk factor for cardiovascular and metabolic disease. Impaired sleep architecture and (or) frequent nocturnal hypoxia are characteristic features in patients with OSA. However, little is known about the sleep parameters linking OSA with glucose metabolism. The objective of this study was to evaluate the association between glycated hemoglobin (HbA1c) and sleep traits from polysomnography and subjective sleep diary in a Chinese population with proven OSA (Huashan OSA Registry Study, Hs-OSARS). Methods 535 participants were recruited in Huashan OSA Registry Study, from January 2018 to August 2021. Objective sleep characteristics were measured via one-night laboratory PSG and biochemical parameters was tested the next morning. Associations were conducted using Pearson’s correlation with adjustments for age, gender, and body mass index (BMI). Regression was used to investigate predictive power of sleep subscales for glucose levels. Results Among the participants, 133 subjects underwent HbA1c and lipid profile (triglyceride, total cholesterol, LDL- and HDL-cholesterol, etc). Age, BMI, ApoE, TC and non-HDL-C (rage=0.281, p=0.001; rBMI =0.249, p=0.004; rApoE=0.250, p=0.004; rTC=0.264, p=0.005; rnon-HDL-C=0.281, p=0.002) had positive associations with HbA1c. Among sleep traits, only stage 3 sleep had a negative association with HbA1c (r=-0.219, p=0.011). After controlling for gender, age and BMI, these associations remained and were statistically significant. Stepwise regression analysis found that non-HDL-C, stage 3 sleep and age were significant predictors retained in the model. Upon fixing the covariates (including gender, age and BMI), TC and stage 3 sleep were significant for predicting HbA1c outcomes. Conclusion Insufficient slow wave sleep is associated with higher blood glucose levels. Our study shows that other PSG indices, such as total sleep time, sleep efficiency, arousal index, apnea-hypopnea index and hypoxemic burden, are not associated with HbA1c. These findings highlight the importance for clinicians to evaluate and improve the slow wave sleep as part of preventing glucose metabolism impairment in OSA patients. Support (if any)