Sleep and cardiometabolic function in obese adolescent girls with polycystic ovary syndrome
Open accessAbstract
Objective To compare the polysomnography findings and cardiometabolic function among adolescent girls with polycystic ovary syndrome (PCOS) and matched female and male controls.Method Retrospective chart review of electronic medical records of 28 girls with PCOS (age: 16.8±1.9 years, body mass index (BMI) Z-score 2.4±0.4), 28 control females (age: 17.1±1.8, BMI Z-score 2.4±0.3) and 28 control males (age: 16.6±1.6, BMI Z-score 2.5±0.5) in a tertiary care centre.Results The prevalence of obstructive sleep apnoea (OSA) was higher in girls with PCOS compared to control females (16/28 (57%) vs. 4/28(14.3%), p<0.01); however, it was comparable to that of the control males (16/28(57%) vs. 21/28(75%), p=0.4). Girls with PCOS had a significantly higher prevalence of insulin resistance compared to control females and control males (20/28 (71.4%) vs. 9/22 (41.0%) (p=0.04) vs. 8/23 (34.8%) (p=0.01). Among girls with PCOS, those with OSA had significantly higher proportions of metabolic syndrome (MetS) (9/16 (56.3%) vs. 1/12 (8.3%) p=0.03), higher insulin resistance (14/16 (87.5%) vs. 6/12 (50%), p=0.04), elevated daytime systolic blood pressure (128.4±12.8 vs. 115.6±11.4, p<0.01), lower high-density lipoprotein (HDL) (38.6±8.7 vs. 49±10.9, p=0.01) and elevated triglycerides (TG) (149.7±87.7 vs. 93.3±25.8, p=0.03) compared to those without OSA.Conclusions We report a higher prevalence of OSA and metabolic dysfunction in a selected group of obese girls with PCOS referred with sleep-related complaints compared to BMI-matched control girls without PCOS. We also report higher prevalence of cardiometabolic dysfunction in girls with PCOS and OSA compared to girls with PCOS without OSA.
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Past cross-sectional studies have shown that obstructive sleep apnea syndrome (OSAS) is highly prevalent in women with polycystic ovary syndrome (PCOS) compared with the general population of reproductive-aged women (17-75% vs. 9-28%).
“Past cross-sectional studies have shown that OSAS is highly prevalent in women with PCOS (15–19) compared with the general population of reproductive-aged women (17-75% vs. 9-28%) (9, 10), with lower rates in adolescents with PCOS (0-57%) (20, 21).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [21]
The Abstract Results report OSA in 57% of the adolescent girls with PCOS studied, supporting the upper end of the adolescent range for which this paper is cited. The Discussion describes a prior adolescent study that did not find increased prevalence, but our copy does not give a 0% rate or establish that rates in adolescents are generally lower than in adults. This study involved obese adolescents referred for sleep evaluation, not adolescents with PCOS generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPast cross-sectional studies have shown lower rates of obstructive sleep apnea syndrome (OSAS) in adolescents with polycystic ovary syndrome (PCOS) (0-57%).
“Past cross-sectional studies have shown that OSAS is highly prevalent in women with PCOS (15–19) compared with the general population of reproductive-aged women (17-75% vs. 9-28%) (9, 10), with lower rates in adolescents with PCOS (0-57%) (20, 21).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [21]
The Results (Polysomnography; page unavailable) report OSA in 57% of obese adolescent girls with PCOS referred for sleep evaluation. The Discussion notes that another adolescent study did not find increased OSA prevalence, but our copy does not give a 0% rate or establish the stated 0–57% range. It also cautions that its referred, obese sample may not represent all adolescents with PCOS. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAll eight included studies employed polysomnography (PSG) to measure obstructive sleep apnea (OSA).
“All eight studies employed PSG to measure OSAS (as this was an inclusion criterion) (15–21, 40), five of which also assessed the presence of other OSAS-related symptoms such as excessive daytime sleepiness (15, 16, 18, 19, 21).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [21]
Only five of the eight included studies adjusted or matched their control group by age, body mass index (BMI) and/or ethnicity.
“with only five of the eight studies having adjusted or matched their control group by age, BMI and/or ethnicity (15, 17, 18, 21, 40).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [21]
Many of their included studies were not included in our meta-analysis due to varying exclusion criteria (e.g., lack of PSG data).
“Many of their included studies were not included in our meta-analysis due to varying exclusion criteria (e.g., lack of PSG data) (16, 21).”
From Obstructive sleep apnea syndrome in polycystic ovary syndrome: a systematic review and meta-analysis (2025) · cites this paper as [21]
The Methods (Study Population and Polysomnography) and Results (Study population; page numbers unavailable) describe a primary study that analyzed girls who underwent PSG. They do not discuss which studies another review included or why the citing authors excluded studies from their meta-analysis. Searches for meta-analysis inclusion, exclusion criteria, and missing PSG data found no passage addressing that comparison. (LLM, conf=0.75)
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References 37 · Cited by 68
Research works printed but not linked: 1
- [32]Redline S Tishler PV Schluchter M Aylor J Clark K Graham G Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems Am J Respir Crit Care Med 5 1999 159 5 Pt 1 1527 32 10228121
- Authors
- Nandalike, K., Agarwal, C., Strauss, T., Coupey, S. M., Isasi, C. R., Sin, S., & Arens, R.
- Affiliations
- Children's Hospital at Montefiore (US)
- Albert Einstein College of Medicine (US)
- Corresponding author
- Arens, Raanan
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 13
- Issue
- 10
- Pages
- 1307-1312
- ISSN
- 1389-9457 (ISSN-L)
- PMC
- PMC3509263
- OpenAlex
- W2148193293
- Cited by
- 68
- References
- 37
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 8 · 2021: 5 · 2020: 3 · 2019: 7 · 2018: 6 · 2017: 8 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 4 · 2012: 2
- FWCI
- 4.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01hl105212-04)
- National Heart, Lung, and Blood Institute (HL105212, R01HL062408, R01 HL-105212)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD053693, HD053693)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- polycystic ovary syndrome, adolescent girls, obesity, obstructive sleep apnea, cardiometabolic function, insulin resistance, metabolic syndrome, sleep-disordered breathing, dyslipidemia, blood pressure, HDL cholesterol, triglycerides, sex differences, polysomnography findings, body mass index, sex hormones
- MeSH terms
- Adolescent, Female, Humans, Insulin Resistance, Male, Obesity, Polycystic Ovary Syndrome, Retrospective Studies, Sex Factors, Sleep, Body Mass Index, Case-Control Studies, Polysomnography, Sleep Apnea, Obstructive, Metabolic Syndrome
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