Circadian impairment of distal skin temperature rhythm in patients with sleep-disordered breathing: the effect of CPAP
Abstract
Study objectives: Our aim was to evaluate the circadian rhythm of distal skin temperature (DST) in sleep-disordered breathing (SDB), its relation to excessive daytime sleepiness and the effect of continuous positive airway pressure (CPAP) on DST. Methods: Eighty SDB patients (53.1 ± 1.2 years old, 27.6% women) and 67 healthy participants (52.3 ± 1.6 years old, 26.9% women) wore a temperature data logger for 1 week. On the last day of that week, SDB patients underwent a polysomnography followed by a Maintenance of Wakefulness Test (MWT), Multiple Sleep Latency Test, and Sustained Attention to Response Task protocol to objectively quantify daytime sleepiness. A subset of 21 moderate to severe SDB patients were treated with CPAP during at least 3 months and revaluated with the same procedure. A nonparametric analysis was performed to characterize DST to assess differences between groups and associations among DST, polysomnography, and daytime sleepiness measures. Results: SDB patients showed an unstable, fragmented, flattened, phase-advanced, and less robust DST rhythm as compared to healthy participants. The more severe the SDB, the worse the DST pattern was, as indicated by the correlation coefficient. Sleepiness, according to MWT sleep latencies, was also associated with the higher fragmentation, lower amplitude, and less robustness of the DST rhythm. Treatment with CPAP improved DST pattern regularity and robustness. Conclusion: DST is altered in SDB, exhibiting a direct relationship to the severity of this condition, and improves with CPAP treatment. DST independently correlates with sleepiness, thus, its measurement may contribute to the understanding of the pathophysiology of sleepiness in these patients.
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Previous human studies have demonstrated diminished temperature amplitude in other populations with disrupted sleep including shift work, metabolic syndrome, and sleep-disordered breathing.
“This is consistent with previous human studies demonstrating diminished temperature amplitude in other populations with disrupted sleep including shift work, metabolic syndrome, and sleep-disordered breathing [[62], [63], [64]].”
From Exercise mitigates sleep-loss-induced changes in glucose tolerance, mitochondrial function, sarcoplasmic protein synthesis, and diurnal rhythms (2021) · cites this paper as [63]
Martinez-Nicolas et al. demonstrated improved circadian temperature amplitude in response to a CPAP intervention.
“In fact, similar to our study, Martinez-Nicolas et al. [63] demonstrated improved circadian temperature amplitude in response to a continuous positive airway pressure (CPAP) intervention, which suggests that physiological interventions can mitigate some circadian aspects of sleep disruption.”
From Exercise mitigates sleep-loss-induced changes in glucose tolerance, mitochondrial function, sarcoplasmic protein synthesis, and diurnal rhythms (2021) · cites this paper as [63]
Disruption of temperature rhythms has been strongly associated with sleep-disordered breathing.
“as well as sleep-disordered breathing16.”
From Diurnal rhythms of wrist temperature are associated with future disease risk in the UK Biobank (2023) · cites this paper as [16]
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Integral Analysis of Circadian Rhythms
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- Authors
- Martinez-Nicolas, A., Guaita, M., Santamaría, J., Montserrat, J. M., Rol, M. Á., & Madrid, J. A.
- Affiliations
- Hospital Clínic de Barcelona (ES)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES)
- Instituto Murciano de Investigación Biosanitaria (ES)
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-04-22
- Volume
- 40
- Issue
- 6
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W2607104068
- Cited by
- 42
- References
- 79
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 6 · 2018: 5
- FWCI
- 3.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- sleep-disordered breathing, obstructive sleep apnea, circadian rhythm, continuous positive airway pressure, excessive daytime sleepiness, sleep fragmentation, CPAP treatment response, temperature loggers
- MeSH terms
- Circadian Rhythm, Female, Humans, Male, Middle Aged, Skin Temperature, Sleep Apnea Syndromes, Sleep Stages, Wakefulness, Case-Control Studies, Polysomnography, Continuous Positive Airway Pressure
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