Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects

Chan Soon Park; Christian Guilleminault; Se Hwan Hwang; Jong Hyun Jeong; Dong Sun Park; Jae Hwan Maeng

doi:10.1016/j.sleep.2013.05.012

Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects

Chan Soon Park, Christian Guilleminault, Se Hwan Hwang, Jong Hyun Jeong, Dong Sun Park, Jae Hwan Maeng

Research output: Contribution to journal › Article › peer-review

27 Scopus citations

Abstract

Objective: Obstructive sleep apnea syndrome (OSAS) is associated with stress system activation involving the hypothalamic-pituitary-adrenocortical (HPA) axis. The relationships among salivary cortisol, a measure of the HPA axis, and objective parameters of polysomnography (PSG) and subjective sleep symptoms were examined. Methods: Our prospective study enrolled 80 children who had a physical examination, underwent overnight PSG, and completed the Korean version of the modified pediatric Epworth sleepiness scale (KMPESS) and OSA-18 (KOSA-18) questionnaires. Saliva was collected at night before PSG and in the early morning after PSG. Results: Subjects ( N= 80) were divided into control ( n= 32, apnea-hypopnea index [AHI]. <. 1) and OSAS ( n= 48, AHI. ≥. 1) groups; the OSAS group was subdivided into mild (1. ≤. AHI. <. 5) and moderate to severe (AHI. ≥. 5) groups. Although salivary cortisol before PSG (n-sCor) did not show a significant change with OSAS severity, salivary cortisol after PSG (m-sCor) significantly decreased with OSAS severity. This decrease resulted in a salivary cortisol ratio (r-sCor) that was significantly different between the control group and the two OSAS subgroups. The m-sCor and sub-sCor of the total group as well as the m-sCor, sub-sCor, and r-sCor of the OSAS group were negatively related to the oxygen desaturation index (ODI). The m-sCor and r-sCor in the OSAS group also were related to subjective sleep symptoms (quality of life [QOL] by KOSA-18). Conclusions: Among the four salivary cortisol parameters, r-sCor was negatively associated with OSAS severity, ODI, and QOL (KOSA-18), which may indicate a chronically stressed HPA axis. These results demonstrate that salivary cortisol may be a useful biomarker of OSAS.

Original language	English
Pages (from-to)	978-984
Number of pages	7
Journal	Sleep Medicine
Volume	14
Issue number	10
DOIs	https://doi.org/10.1016/j.sleep.2013.05.012
State	Published - Oct 2013

Bibliographical note

Funding Information:
Support for this study was provided by the Alumni of Department of Otolaryngology-HNS, the Catholic University of Korea, College of Medicine, and by the Catholic Medical Center Research Foundation made in the program year of 2012.

Funding Information:
This paper was financially support by the Alumni of Department of Otolaryngology-HNS, The Catholic University of Korea, College of Medicine , and by the Catholic Medical Center Research Foundation made in the program year of 2012, all of whom had no further roles in the analysis and interpretation of data, the writing of paper, and the submission of the paper to the journal.

Keywords

Child
Cortisol
Polysomnography
Saliva
Sleep-disordered breathing
Stress

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10.1016/j.sleep.2013.05.012

Cite this

@article{e56231a359fd41d28cb4f1a87430da08,

title = "Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects",

abstract = "Objective: Obstructive sleep apnea syndrome (OSAS) is associated with stress system activation involving the hypothalamic-pituitary-adrenocortical (HPA) axis. The relationships among salivary cortisol, a measure of the HPA axis, and objective parameters of polysomnography (PSG) and subjective sleep symptoms were examined. Methods: Our prospective study enrolled 80 children who had a physical examination, underwent overnight PSG, and completed the Korean version of the modified pediatric Epworth sleepiness scale (KMPESS) and OSA-18 (KOSA-18) questionnaires. Saliva was collected at night before PSG and in the early morning after PSG. Results: Subjects ( N= 80) were divided into control ( n= 32, apnea-hypopnea index [AHI]. <. 1) and OSAS ( n= 48, AHI. ≥. 1) groups; the OSAS group was subdivided into mild (1. ≤. AHI. <. 5) and moderate to severe (AHI. ≥. 5) groups. Although salivary cortisol before PSG (n-sCor) did not show a significant change with OSAS severity, salivary cortisol after PSG (m-sCor) significantly decreased with OSAS severity. This decrease resulted in a salivary cortisol ratio (r-sCor) that was significantly different between the control group and the two OSAS subgroups. The m-sCor and sub-sCor of the total group as well as the m-sCor, sub-sCor, and r-sCor of the OSAS group were negatively related to the oxygen desaturation index (ODI). The m-sCor and r-sCor in the OSAS group also were related to subjective sleep symptoms (quality of life [QOL] by KOSA-18). Conclusions: Among the four salivary cortisol parameters, r-sCor was negatively associated with OSAS severity, ODI, and QOL (KOSA-18), which may indicate a chronically stressed HPA axis. These results demonstrate that salivary cortisol may be a useful biomarker of OSAS.",

keywords = "Child, Cortisol, Polysomnography, Saliva, Sleep-disordered breathing, Stress",

author = "Park, {Chan Soon} and Christian Guilleminault and Hwang, {Se Hwan} and Jeong, {Jong Hyun} and Park, {Dong Sun} and Maeng, {Jae Hwan}",

note = "Funding Information: Support for this study was provided by the Alumni of Department of Otolaryngology-HNS, the Catholic University of Korea, College of Medicine, and by the Catholic Medical Center Research Foundation made in the program year of 2012. Funding Information: This paper was financially support by the Alumni of Department of Otolaryngology-HNS, The Catholic University of Korea, College of Medicine , and by the Catholic Medical Center Research Foundation made in the program year of 2012, all of whom had no further roles in the analysis and interpretation of data, the writing of paper, and the submission of the paper to the journal.",

year = "2013",

month = oct,

doi = "10.1016/j.sleep.2013.05.012",

language = "English",

volume = "14",

pages = "978--984",

journal = "Sleep Medicine",

issn = "1389-9457",

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T1 - Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects

AU - Park, Chan Soon

AU - Guilleminault, Christian

AU - Hwang, Se Hwan

AU - Jeong, Jong Hyun

AU - Park, Dong Sun

AU - Maeng, Jae Hwan

N1 - Funding Information: Support for this study was provided by the Alumni of Department of Otolaryngology-HNS, the Catholic University of Korea, College of Medicine, and by the Catholic Medical Center Research Foundation made in the program year of 2012. Funding Information: This paper was financially support by the Alumni of Department of Otolaryngology-HNS, The Catholic University of Korea, College of Medicine , and by the Catholic Medical Center Research Foundation made in the program year of 2012, all of whom had no further roles in the analysis and interpretation of data, the writing of paper, and the submission of the paper to the journal.

PY - 2013/10

Y1 - 2013/10

N2 - Objective: Obstructive sleep apnea syndrome (OSAS) is associated with stress system activation involving the hypothalamic-pituitary-adrenocortical (HPA) axis. The relationships among salivary cortisol, a measure of the HPA axis, and objective parameters of polysomnography (PSG) and subjective sleep symptoms were examined. Methods: Our prospective study enrolled 80 children who had a physical examination, underwent overnight PSG, and completed the Korean version of the modified pediatric Epworth sleepiness scale (KMPESS) and OSA-18 (KOSA-18) questionnaires. Saliva was collected at night before PSG and in the early morning after PSG. Results: Subjects ( N= 80) were divided into control ( n= 32, apnea-hypopnea index [AHI]. <. 1) and OSAS ( n= 48, AHI. ≥. 1) groups; the OSAS group was subdivided into mild (1. ≤. AHI. <. 5) and moderate to severe (AHI. ≥. 5) groups. Although salivary cortisol before PSG (n-sCor) did not show a significant change with OSAS severity, salivary cortisol after PSG (m-sCor) significantly decreased with OSAS severity. This decrease resulted in a salivary cortisol ratio (r-sCor) that was significantly different between the control group and the two OSAS subgroups. The m-sCor and sub-sCor of the total group as well as the m-sCor, sub-sCor, and r-sCor of the OSAS group were negatively related to the oxygen desaturation index (ODI). The m-sCor and r-sCor in the OSAS group also were related to subjective sleep symptoms (quality of life [QOL] by KOSA-18). Conclusions: Among the four salivary cortisol parameters, r-sCor was negatively associated with OSAS severity, ODI, and QOL (KOSA-18), which may indicate a chronically stressed HPA axis. These results demonstrate that salivary cortisol may be a useful biomarker of OSAS.

AB - Objective: Obstructive sleep apnea syndrome (OSAS) is associated with stress system activation involving the hypothalamic-pituitary-adrenocortical (HPA) axis. The relationships among salivary cortisol, a measure of the HPA axis, and objective parameters of polysomnography (PSG) and subjective sleep symptoms were examined. Methods: Our prospective study enrolled 80 children who had a physical examination, underwent overnight PSG, and completed the Korean version of the modified pediatric Epworth sleepiness scale (KMPESS) and OSA-18 (KOSA-18) questionnaires. Saliva was collected at night before PSG and in the early morning after PSG. Results: Subjects ( N= 80) were divided into control ( n= 32, apnea-hypopnea index [AHI]. <. 1) and OSAS ( n= 48, AHI. ≥. 1) groups; the OSAS group was subdivided into mild (1. ≤. AHI. <. 5) and moderate to severe (AHI. ≥. 5) groups. Although salivary cortisol before PSG (n-sCor) did not show a significant change with OSAS severity, salivary cortisol after PSG (m-sCor) significantly decreased with OSAS severity. This decrease resulted in a salivary cortisol ratio (r-sCor) that was significantly different between the control group and the two OSAS subgroups. The m-sCor and sub-sCor of the total group as well as the m-sCor, sub-sCor, and r-sCor of the OSAS group were negatively related to the oxygen desaturation index (ODI). The m-sCor and r-sCor in the OSAS group also were related to subjective sleep symptoms (quality of life [QOL] by KOSA-18). Conclusions: Among the four salivary cortisol parameters, r-sCor was negatively associated with OSAS severity, ODI, and QOL (KOSA-18), which may indicate a chronically stressed HPA axis. These results demonstrate that salivary cortisol may be a useful biomarker of OSAS.

KW - Child

KW - Cortisol

KW - Polysomnography

KW - Saliva

KW - Sleep-disordered breathing

KW - Stress

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DO - 10.1016/j.sleep.2013.05.012

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SN - 1389-9457

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SP - 978

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JO - Sleep Medicine

JF - Sleep Medicine

IS - 10

ER -

Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects

Abstract

Bibliographical note

Keywords

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