Skip to main content

Advertisement

SpringerLink
Log in

Independent association between hypoxemia and night sweats in obstructive sleep apnea

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Purpose

To assess the relationship between hypoxemia during polysomnography (PSG) and patient-reported night sweats (NS).

Methods

This retrospective observational study included adult patients who completed a standardized sleep questionnaire and the Epworth Sleepiness Scale (ESS) before PSG.

Results

We included 1397 patients (41% women). The median age was 52 years, 80% had obstructive sleep apnea (OSA) defined as an apnea–hypopnea index (AHI) ≥ 5, and 35% were obese. A total of 245 patients (17.5%) reported NS. Their prevalence was higher among patients with OSA compared to controls (18.9% vs. 12.2%, p < 0.01). In the bivariate analysis, the variables associated with NS were BMI, AHI, hypoxemia (T90 ≥ 2.5% of total recording time plus minimum SO2 < 85%), frequent body movements or awakenings, nightmares, excessive daytime sleepiness (Epworth > 10), nocturia, cardiovascular events, and the use of sedatives or antidepressants. In the multivariate model, the independent predictors of NS were BMI (OR: 1.47, CI 95%: 1.07–2.01, p = 0.016), hypoxemia (OR: 1.87, CI 95%: 1.37–2.60, p = 0.0001), nightmares (OR: 2.60, CI 95%: 1.73–3.80, p < 0.0001), frequent body movements and awakenings (OR: 1.57, CI 95%: 1.16–2.11, p = 0.003 and OR: 1.54, CI 95%: 1.13–2.08, p = 0.005, respectively), and excessive daytime sleepiness (OR: 1.65, CI 95%: 1.24–2.20, p = 0.0007).

Conclusions

In patients with OSA, night sweats were significantly and independently associated with a higher hypoxic burden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Hurley HJ (2001) The eccrine sweat glands: structure and function. In: Freinkel R, Wooley D (eds) Biology of the skin. The Parthenon Publishing Group, pp 46–76

  2. Baker LB (2019) Physiology of sweat gland function: the roles of sweating and sweat composition in human health. Temperature (Austin) 6:211–259

    Article  PubMed  Google Scholar 

  3. Mold JW, Holtzclaw BJ, McCarthy L (2012) Night sweats: a systematic review of the literature. J Am Board Fam Med 25:878–893

    Article  PubMed  Google Scholar 

  4. Bryce C (2020) Persistent night sweats: diagnostic evaluation. Am Fam Physician 102:427–433

    PubMed  Google Scholar 

  5. Smetana GW (2021) Evaluation of the patient with night sweats or generalized hyperhidrosis. In: Aronson MD, Kunnins L (eds) UpToDate. Waltham, MA

    Google Scholar 

  6. Arnardottir ES, Janson C, Bjornsdottir E, Benediktsdottir B, Juliusson S, Kuna ST, Pack AI, Gislason T (2013) Nocturnal sweating-a common symptom of obstructive sleep apnoea: the Icelandic sleep apnoea cohort. BMJ Open 3(5):e002795

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cruz IA, Drummond M, Winck JC (2012) Obstructive sleep apnea symptoms beyond sleepiness and snoring: effects of nasal APAP therapy. Sleep Breathing 16:361–366

    Article  PubMed  Google Scholar 

  8. Narkiewicz K, Somers VK (2003) Sympathetic nerve activity in obstructive sleep apnoea. Acta Physiol Scand 177:385–390

    Article  CAS  PubMed  Google Scholar 

  9. Peltier AC, Consens FB, Sheikh K, Wang L, Song Y, Russell JW (2007) Autonomic dysfunction in obstructive sleep apnea is associated with impaired glucose regulation. Sleep Med 8:149–155

    Article  PubMed  Google Scholar 

  10. Woodson BT, Brusky LT, Saurajen A, Jaradeh S (2004) Association of autonomic dysfunction and mild obstructive sleep apnea. Otolaryngol Head Neck Surg 130:643–648

    Article  PubMed  Google Scholar 

  11. Somers VK, Mark AL (1985) Zavala DC and Abboud FM (1989) Contrasting effects of hypoxia and hypercapnia on ventilation and sympathetic activity in humans. J Appl Physiol 67:2101–2106

    Article  Google Scholar 

  12. Jouett NP, Watenpaugh DE, Dunlap ME, Smith ML (2015) Interactive effects of hypoxia, hypercapnia and lung volume on sympathetic nerve activity in humans. Exp Physiol 100:1018–1029

    Article  CAS  PubMed  Google Scholar 

  13. Mold JW, Goodrich S, Orr W (2008) Associations between subjective night sweats and sleep study findings. J Am Board Fam Med 21:96–100

    Article  PubMed  Google Scholar 

  14. Iber C, Ancoli-Israel S, Chesson AL Jr, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine, Westchester, IL

    Google Scholar 

  15. (1992) EEG arousals: scoring rules and examples. A preliminary report from the sleep disorders atlas task force of the american sleep disorder association. Sleep 15:173–184

  16. Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM (2012) American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 8:597–619

    Article  PubMed  PubMed Central  Google Scholar 

  17. Schildkraut JM, Cooper GS, Halabi S, Calingaert B, Hartge P, Whittemore AS (2001) Age at natural menopause and the risk of epithelial ovarian cancer. Obstet Gynecol 98:85–90

    CAS  PubMed  Google Scholar 

  18. Somers VK, Mark AL, Abboud FM (1988) Sympathetic activation by hypoxia and hypercapnia—implications for sleep apnea. Clin Exp Hypertens A 10(Suppl 1):413–422

    PubMed  Google Scholar 

  19. Kacin A, Golja P, Eiken O et al (2007) The influence of acute and 23 days of intermittent hypoxic exposures on the exercise-induced forehead sweating response. Eur J Appl Physiol 99:557–566

    Article  PubMed  Google Scholar 

  20. Somers VK, Dyken ME, Mark AL, Abboud FM (1993) Sympathetic nerve activity during sleep in normal subjects. N Engl J Med 328:303–307

    Article  CAS  PubMed  Google Scholar 

  21. Paradiso S, Robinson RG, Andreasen NC, Downhill JE, Davidson RJ, Kirchner PT, Watkins GL, Ponto LL, Hichwa RD (1997) Emotional activation of limbic circuitry in elderly normal subjects in a PET study. Am J Psychiatry 154:384–389

    Article  CAS  PubMed  Google Scholar 

  22. Buresh R, Berg K, Noble J (2005) Heat production and storage are positively correlated with measures of body size/composition and heart rate drift during vigorous running. Res Q Exerc Sport 76:267–274

    Article  PubMed  Google Scholar 

  23. Punjabi NM, Haponik E (2000) Ask about daytime sleepiness! J Am Geriatr Soc 48:228–229

    Article  CAS  PubMed  Google Scholar 

  24. Idiaquez J, Santos I, Santin J, Del Rio R, Iturriaga R (2014) Neurobehavioral and autonomic alterations in adults with obstructive sleep apnea. Sleep Med 15:1319–1323

    Article  PubMed  Google Scholar 

  25. Baumert M, Immanuel SA, Stone KL, Litwack Harrison S, Redline S, Mariani S, Sanders P, McEvoy RD, Linz D (2020) Composition of nocturnal hypoxaemic burden and its prognostic value for cardiovascular mortality in older community-dwelling men. Eur Heart J 41:533–541

    Article  PubMed  Google Scholar 

  26. Labarca G, Jorquera J, Dreyse J, Salas C, Letelier F (2021) Hypoxemic features of obstructive sleep apnea and the risk of mortality: a cluster analysis. Sleep Breathing 25:95–103

    Article  PubMed  Google Scholar 

  27. Chen F, Chen K, Zhang C, Chen X, Huang J, Jia P, Ma J, Zhang J, Fang J, Wang G (2018) Evaluating the clinical value of the hypoxia burden index in patients with obstructive sleep apnea. Postgrad Med 130:436–441

    Article  PubMed  Google Scholar 

  28. Muka T, Oliver-Williams C, Colpani V, Kunutsor S, Chowdhury S, Chowdhury R, Kavousi M, Franco OH (2016) Association of vasomotor and other menopausal symptoms with risk of cardiovascular disease: a systematic review and meta-analysis. PLoS ONE 11:e0157417

    Article  PubMed  PubMed Central  Google Scholar 

  29. Arnardottir ES, Thorleifsdottir B, Svanborg E, Olafsson I, Gislason T (2010) Sleep-related sweating in obstructive sleep apnoea: association with sleep stages and blood pressure. J Sleep Res 19:122–130

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sleep Laboratory, Pneumonology, Hospital Alemán, Pueyrredón 1640, 1418, Buenos Aires, CP, Argentina

    Carlos Alberto Nigro & Ignacio Bledel

  2. Sleep Laboratory, Pneumonology, Hospital Británico, Buenos Aires, Argentina

    Eduardo Borsini

Authors
  1. Carlos Alberto Nigro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ignacio Bledel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eduardo Borsini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carlos Alberto Nigro.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional committee and the 1964 Helsinki Declaration and its later amendments. This study was approved by the Ethics Committee of Hospital Alemán. Informed consent was exempted given the retrospective nature of the study and the fact that the polysomnograms performed were part of the routine diagnostic evaluation of patients referred to the sleep laboratory.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 31 KB)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nigro, C.A., Bledel, I. & Borsini, E. Independent association between hypoxemia and night sweats in obstructive sleep apnea. Sleep Breath 27, 1043–1048 (2023). https://doi.org/10.1007/s11325-022-02701-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-022-02701-3

Keywords

Search

Navigation