Measurement of changes in cytochrome oxidase redox state during obstructive sleep apnea using near-infrared spectroscopy.
OBJECTIVE
To use near-infrared spectroscopy to investigate the effect of obstructive sleep apnea on cytochrome oxidase, the terminal enzyme of the mitochondrial respiratory chain.


METHODS
Observational study.


METHODS
Teaching hospital sleep unit.


METHODS
Subjects with diagnosed moderate to severe obstructive sleep apnea were recruited from the sleep clinic.


METHODS
Subjects were invited to attend 2 daytime sleep-study sessions, which included near-infrared monitoring of cerebral oxygenation and cytochrome-oxidase oxidation state. In addition, in study session 1, full polysomnography was performed (8 subjects, 303 apneas), and in study session 2, arterial oxygen saturation, cerebral blood flow velocity, and blood pressure were monitored (7 subjects, 287 apneas).


RESULTS
In study session 1, mean (+/- SD) cytochrome-oxidase changes ranged from 0.48 +/- 0.08 microM to 0.13 +/- 0.05 microM. The magnitude of cytochrome-oxidase change correlated significantly with the magnitude of change in the cerebral tissue oxygenation index (P < .001). In study session 2, there were significant correlations between arterial oxygen-saturation changes and cytochrome-oxidase redox changes and between Doppler cerebral blood flow velocity changes and cytochrome-oxidase redox changes (P < .001 and P = .001, respectively).


CONCLUSIONS
Changes in directly measured cerebral tissue saturation and changes in arterial saturation and cerebral blood flow velocity (the 2 main factors affecting cerebral oxygenation) are associated with changes in cytochrome-oxidase oxidation state. The reduced cerebral oxygenation that occurs during obstructive sleep apnea is associated with changes in the intracellular redox state.
McGown
Anne D
AD
Department of Thoracic Medicine, University College London, UK. amcgown@doctors.org.uk
Makker
Himender
H
Elwell
Clare
C
Al Rawi
Pippa G
PG
Valipour
Arschang
A
Spiro
Stephen G
SG
D000328:Adult; D001921:Brain / Q000098:blood supply / Q000378:metabolism; D003576:Electron Transport Complex IV / Q000378:metabolism*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D010084:Oxidation-Reduction; D010100:Oxygen / Q000378:metabolism; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000201:enzymology* / Q000628:therapy; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
D003576:Electron Transport Complex IV; D010100:Oxygen