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Oxygen saturation during sleep as a predictor of inflammation in anovulatory women

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

To evaluate the inflammatory profile of premenopausal women with anovulatory cycles, regular menstrual cycles, or using contraceptives, and the associations with sleep and health-related parameters.

Methods

Subjects completed questionnaires including the Pittsburgh Sleep Quality Index and the Epworth sleepiness scale, underwent whole-night polysomnography, and had blood collected for analysis of inflammatory, cardiovascular, and hormonal parameters. Women of reproductive age were categorized into three groups for comparisons: anovulatory menstrual cycles, regular menstrual cycles, and hormonal contraceptive use.

Results

Women with anovulatory menstrual cycles (n = 20) had higher circulating levels of the proinflammatory cytokine IL-6 compared with women who had regular menstrual cycles (n = 191) and those on hormonal contraception (n = 72). No other classical marker of low-grade inflammation was significantly different. Subjective and objective sleep data were similar among groups. However, the mean peripheral oxygen saturation (SpO2) during sleep was reduced in anovulatory women. The analysis of associated variables of the inflammatory profile demonstrated that mean SpO2 during sleep was a predictive factor of IL-6 levels.

Conclusions

Our data suggest that in premenopausal women with anovulation, a proinflammatory condition mediated by IL-6 is associated with lower oxygen levels during sleep. These findings reflect the balance between gynecological status, the immune system, and sleep, pointing to the need to control for these factors in clinical practice and research contexts.

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Availability of data and material

The authors declare that all data and materials support the published claims and comply with field standards.

Funding

This study was supported by the Associação Fundo de Incentivo à Pesquisa (AFIP). MLA, HH, LB, and ST are recipients of fellowships from CNPq. The funding agencies had no role in the design, preparation, review, or approval of this study.

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Author notes

  1. Paula Araujo and Daniel Ninello Polesel contributed equally to this work.

Authors and Affiliations

  1. Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925, Vila Clementino, São Paulo, SP, 04024-002, Brazil

    Paula Araujo, Daniel Ninello Polesel, Helena Hachul, Lia Rita Azeredo Bittencourt, Sergio Tufik & Monica Levy Andersen

  2. Department of Physiological Sciences, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil

    Paula Araujo

  3. Departamento de Ginecologia, Casa de Saúde Hospital Santa Marcelina, São Paulo, Brazil

    Helena Hachul

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  1. Paula Araujo
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  3. Helena Hachul
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  4. Lia Rita Azeredo Bittencourt
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  5. Sergio Tufik
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Contributions

DNP, HH, MLA, PA, and ST made substantial contributions to the conception or design of the study. DNP and PA made substantial contributions to the acquisition, analysis, or interpretation of data for the study. All authors were involved in the writing of the manuscript or revising it critically for important intellectual content, and approved the final version to be published.

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Correspondence to Monica Levy Andersen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed were in accordance with the ethical standards of the Institutional and National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethical Research Committee at the Universidade Federal de São Paulo (CEP #0593/06) and registered in ClinicalTrials.gov (NCT00596713).

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Araujo, P., Polesel, D.N., Hachul, H. et al. Oxygen saturation during sleep as a predictor of inflammation in anovulatory women. Sleep Breath 25, 1247–1255 (2021). https://doi.org/10.1007/s11325-020-02233-8

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  • DOI: https://doi.org/10.1007/s11325-020-02233-8

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