Cortisol provides an important link between the immune system, sleep, and psychological stress. High levels of cortisol suppress the immune system, so excessively tired people are more susceptible to illness.
Sleep disruption and sustained psychological stress increase cortisol concentration in the blood. Indeed, one night of lost sleep can raise cortisol concentrations by almost 50% by the following evening. High levels of cortisol suppress the immune system, so excessively tired people are more susceptible to illness (Foster and Wulff 2005). Indeed, one night of lost sleep can raise cortisol concentrations by almost 50% by the following evenings (Leprout, Copinschi, Buxton, and Van Cauter 1997). We studied circadian rhythms of cortisol in children with severe OSAS. Cortisol concentrations were determined every second hour between 8.00 p.m. and 8.00 a.m. during a 12 channels polisomnography. Cortisol among OSAS pediatric patients presented a significant growth in the interval included between 0.00 and 4.00 a.m. compared to healthy controls. Sleep disruption and hypoxia in patients with OSAS increase cortisol concentration in the blood. We found a significant correlation between cortisol circadian secretion and BMI (Nosetti et al. 2006) (Fig. 16.2).
Night trend of cortisol mean values - OSAS\control subjects tf> <
Night trend of cortisol mean values - OSAS\control subjects
Figure 16.2. Comparison of the night trend of cortisol (ng/ml) between OSAS patients and control subjects.
Obese pediatric patient with OSAS have an increased risk of insulin resistance, hypertension, and increase in inflammatory markers. These metabolic abnormalities improve with treatment of OSAS, indicating that OSAS plays a direct role in their development (de la Eva, Baur, Donague, and Waters 2002).
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