Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, affecting approximately one in ten women. It is characterized by anovulation, elevated androgen levels, and is associated with multiple comorbidities, including obesity, insulin resistance, dyslipidemia, gestational diabetes , type 2 diabetes, high blood pressure, nonalcoholic fatty liver disease, reduced quality of life, and cardiovascular disease.
Recent studies suggest that obesity and elevated androgen levels, common in women with PCOS, favor the development of obstructive sleep apnea (OSA). A systematic review (Helvaci N. et al., 2017) reported that the prevalence of OSA in women with PCOS is 32%.
OSA is one of the most common respiratory disorders, characterized by fragmented sleep architecture due to awakenings and recurrent breathing pauses caused by total (apnea) or partial (hypopnea) obstruction of the upper airways for at least 10 seconds. These alterations lead to periodic fluctuations in heart rate, blood pressure, sympathetic activity, intrathoracic pressure, and oxygen saturation.
The relationship between OSA and PCOS is still under investigation. Current evidence links it to alterations in sex steroids (elevated androgens and low estrogen) and increased visceral adiposity. Obesity is common in patients with both conditions, and OSA shares several comorbidities with PCOS, including insulin resistance, gestational diabetes, type 2 diabetes, hypertension, cardiovascular disease, reduced quality of life, and increased mortality. Therefore, it is plausible that the two disorders coexist and exacerbate one another’s complications.
However, healthcare practitioners caring for women with PCOS do not always account for the high prevalence of OSA. For this reason, PCOS patients should be screened using sleep apnea questionnaires and assessments of excessive daytime drowsiness. Positive cases should undergo specific apnea screening .
Further research is needed to fully clarify the causal mechanisms. A better understanding of the relationship between OSA and PCOS will allow for more effective therapeutic strategies and improved patient care.
Sources:
Helvaci N, Karabulut E, Demir AU, Yildiz BO. Polycystic ovary syndrome and the risk of obstructive sleep apnea: a meta-analysis and review of the literature. Endocrine Connections, v. 6, p. 437–445, Oct. 2017.
By Dr. Diógenes Freire – Physician
CRM [Brazilian Federal Council of Medicine] 4231-SE
Instagram:@drdiogenesfreire
Website http://drdiogenesfreire.com/
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