 Polycystic
Ovarian Syndrome (PCOS) is one of the most common disorders of the female
endocrine system. It is estimated that 5-10% of all women and as many as
17% of Hispanic women struggle with PCOS symptoms. Characterized by an
abnormally high level of the male hormone, testosterone, irregular periods,
infertility and Insulin Resistance, research is now showing that these
hormone imbalances may also predispose women with Polycystic Ovarian Syndrome
to additional health problems (1).
One such problem is Obstructive Sleep Apnea (OSA), the involuntary closure
of the upper airway which causes one to stop breathing while sleeping (2).
Sufferers are typically not awakened by the repeated nightly episodes,
but others awake with the experience of being choked or asphyxiated. Symptoms
of Sleep Apnea include: chronic loud snoring, gasping/choking episodes
during sleep, excessive daytime sleepiness and personality changes (3).
Snoring is not amusing
 In
the past, excessive snoring and sputtering was fertile ground for jokes,
but researchers have discovered that Sleep Apnea is no joking matter. Individuals
with Sleep Apnea are three times more likely to be involved in motor vehicle
accidents. They are less productive workers and can exhibit problems associated
with poor memory and judgment. They are more likely to suffer depression
and other psychiatric disorders and they are prone to a series of chronic
diseases such as diabetes, thyroid disorders, cancers and cardiovascular
disease (4).
This connection between sleep disruption and chronic disease is being rigorously
investigated. Science tells us that the true purpose of sleep is not entirely
understood. It appears to fulfill certain important physiological functions
such as restoration, neurological development and maintenance, memory consolidation,
physical growth and maturation and immune system strengthening (5). Sleep
is fundamental to the proper functioning of these systems (and likely others)
which sustain our health and sense of well being. Sleep disruption can
therefore, negatively affect and/or inhibit the most basic physiological
functioning, causing a ripple-effect throughout the body.
Sleep Apnea, PCOS and Insulin Resistance
 It
is not surprising then, that researchers have discovered that Sleep Apnea
may be connected to the same hormone imbalances within the endocrine system
that result in other PCOS symptoms.
Studies show that women with Polycystic Ovarian Syndrome have an exceptionally
high risk of sleep apnea (6). Increased weight and obesity may play a significant
role. High BMI (Body Mass Index) contributes to an insulin imbalance that
results in a cascade of problems related to Insulin Resistance, the inability
of the body to effectively process glucose. Because of a series of biochemical
errors, insulin is unable to successfully bind to cells, inhibiting its
ability to transfer glucose into those cells to be converted into energy.
This causes a build up of both insulin and glucose in the blood that contributes
to the accumulation of plaque in blood vessels.
Studies indicate that Insulin Resistance may be a stronger risk factor
than excessive testosterone in the incidence of PCOS. In a controlled study,
women with Polycystic Ovarian Syndrome were 30 times more likely to suffer from sleep disordered
breathing and reported higher frequencies of daytime sleepiness than the
control group.
Researchers also found that while testosterone levels between the two groups
were comparable; their fasting plasma insulin levels were significantly
higher, indicating that sleep apnea might reflect an insulin-related endocrine
abnormality (7). These findings further confirm the link between PCOS,
Insulin Resistance and higher incidences of diabetic conditions.
Testosterone and Vascular Issues
 Elevated
testosterone, a commonly-presented symptom of Polycystic Ovarian Syndrome
is also linked to vascular problems. According to some research, excess
testosterone contributed to the development of a thickened carotid artery
and larger neck present in many women with PCOS, suggesting that the "masculinizing" effect
of testosterone affects the physiology of the breathing mechanism; a reasonable
assumption since the predominance of Sleep Apnea sufferers are male until
post-menopausal women start to statistically catch up (8). Other researchers
point to the connection between Insulin Resistance and the thickening of
vascular walls. Both situations are harbingers of serious cardiovascular
disease and should prompt quick action.
Treatment
Treatment for Sleep Apnea in individuals with Polycystic Ovarian Syndrome should be administered by
a responsible healthcare professional that is thoroughly familiar with
both the complexities of Polycystic Ovarian Syndrome and the overlapping
conditions indicated by the presence of Sleep Apnea. And while there are
prescriptions available that address the list of symptoms, the most important
thing a woman with PCOS could do on their own is to make substantive changes
to her diet, nutrition and activity levels.
As in non-PCOS individuals, weight loss, nutritional supplementation and
exercise can change the biochemistry of the body, helping to bring it into
balance. With weight loss due to a low carbohydrate diet, Insulin Resistance
becomes less of a problem, hormone levels start to even out, cardiovascular
risk starts to drop and energy starts to increase. Perhaps more importantly,
however, is the soaring sense of self esteem that comes from taking control
of one's own health.
You may be interested in some of our Frequently
Asked Questions (FAQs) on PCOS and the Insulite PCOS System.
(1-5) Two
Challenges in Women's Healthcare: Sleep Disorders and Polycystic
Ovary Syndrome – Lynch JS, Medscape.
(6,8) PCOS
Health Risks – Ehrman DA, Rosenfield RL, Imperial J,
Rue A, The University of Chicago Medical Center Website.
(7) Polycystic
ovary syndrome is associated with obstructive sleep apnea and daytime
sleepiness: role of insulin resistance
– Vgontzas AN, Legro RS, Bixler EO, Grayev A, Kales A, Chrousos
GP. J Clin Endocrinol Metab. 2001 Feb;86(2):517-20, PMID: 11158002.
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