Oxygen saturation during sleep as a predictor of inflammation in anovulatory women
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SLEEP BREATHING PHYSIOLOGY AND DISORDERS • ORIGINAL ARTICLE
Oxygen saturation during sleep as a predictor of inflammation in anovulatory women Paula Araujo 1,2 & Daniel Ninello Polesel 1 & Helena Hachul 1,3 & Lia Rita Azeredo Bittencourt 1 & Sergio Tufik 1 & Monica Levy Andersen 1 Received: 19 June 2020 / Revised: 16 September 2020 / Accepted: 16 October 2020 # Springer Nature Switzerland AG 2020
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. Keywords Anovulation . Cytokines . Inflammation . IL-6 . Menstrual cycle . Sleep . Women
Introduction Inflammatory profile alterations are involved in a diverse range of normal and pathological conditions. The close link between immune response and sex hormones suggests that the magnitude of these alterations could be related to Paula Araujo and Daniel Ninello Polesel contributed equally to this work. * Monica Levy Andersen [email protected] 1
Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925, Vila Clementino, São Paulo, SP 04024-002, Brazil
2
Department of Physiological Sciences, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil
3
Departamento de Ginecologia, Casa de Saúde Hospital Santa Marcelina, São Paulo, Brazil
gynecological status in women [1, 2]. Variations in inflammatory markers have been described across the menstrual cycle as result of hormonal changes during the ovarian cycle [3–5]. Disruption of the regular menstrual cycle could
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