Evaluation of cortisol levels in patients with obstructive sleep apnea syndrom

Introduction and Objective: Obstructive Sleep Apnea Syndrom (OSAS) is a most commonly form of apnea in society. Breathing difficulty during sleep, apneas, and oxygene desaturations cause stress in individuals, leading to increased hypophysis adrenal axis activities.In this study, our aim is to compare night cortisol levels, morning cortisol levels, 24-hour free cortisol test measurements between individuals with OSAS and healthy subjects. Material and Method: A total of 50 cases ( 25 controls and 25 individuals with OSAS ) with body mass index ?30, who had OSAS symptoms such as snoring, daytime sleepiness and witnessed apnea, and who had been admitted to the department of Endocrinology, Dicle University, between January 2012 and September 2013. Blood samples were taken to be tested. During night hospitalization, their cortisol levels were measured at 23.00 o?clock at night and at 8.00 in the morning. On the following days, 24-hour urine was taken, and free cortisol level was measured. Then, 1 mg dexametazon suppression test was performed at 23.00 o?clock at night. Findings: Mean age of the control group was 43,76±8,36, whereas that of OSAS group was 46,68±5,75 (p>0,05). Of the cases involved in the study, morning cortisol level was found to be 12,47± 6,25 in controls, and 12,05 ±4,57 in OSAS group (p<0,05). Night cortisol level, however, was 3,82± 3,19 in controls, but 6,18± 3,19 in the OSAS group ( p<0,01) As for 24-hour free urine cortisol levels in controls and OSAS group, they were found to be 44,33 ± 42,07 and 81,96± 68,04, respectively (p<0,05).One mg dexametazon test result was 0,87± 0,45 in controls and 1,53± 1,09 in OSAS group (p<0,01). Suppression did not occur in one subject (%4) in the control group, but in 5 (%20) patients in the OSAS group. When 2 mg dexametazon suppression was administered to those not suppressed, suppression occurred in all of them. Conclusion: In those patients diagnosed with OSAS, night cortisol levels and 24-hour free cortisol level in urine are seen high.