[Exhaled nitric oxide in patients with obstructive sleep apnea syndrome].
Exhaled nitric oxide has been extensively investigated as a non-invasive marker of airway inflammation. Some authors have suggested that morning FE(NO) in obstructive sleep apnea syndrome (OSAS) patients is elevated due to inflammation of upper airways, while others have not found any differences between patients and healthy subjects. The purpose of this study was to analyze concentration of exhaled nitric oxide (FE(NO)) in OSAS patients.


METHODS
119 (99 M, 20 F) consecutive patients of sleep laboratory participated in this study. Standard overnight sleep studies with polysomnography or portable screening device were carried out in the whole group: OSAS was diagnosed in 66 patients and 53 no-OSAS served as controls. FE(NO) was measured on-line with a flow rate kept at 0.045 - 0.055 l/s, according to the recommendations of ATS using a chemiluminescence analyzer twice: before the sleep study (8-10 p.m.) and after termination of data collection (6 - 8 a.m.). There were no differences in age between patients and controls. Respiratory disturbance index (RDI) was 40.3+/-24.9 in patients and 3.7+/-2.8 in controls (p<0.001). In OSAS patients both evening and morning FE(NO) was significantly higher compared to controls (23.1+/-14.8 ppb vs. 16.8+/-9.8 ppb and 22.4+/-13.2 ppb vs. 15.3+/-8.1 ppb respectively, p<0.05). Weak but statistically significant correlations for the whole group between morning FE(NO) and mean and minimum arterial oxygen saturation (SaO2) during sleep and number of study minutes with SaO2<90% were observed. Lower evening FE(NO) in OSAS patients with coexisting arterial hypertension when compared to normotensive OSAS patients was also noticed (19.1+/-10.8 ppb vs. 27.1+/-19.1 ppb; p<0.05).


CONCLUSIONS
The increase in FE(NO) in OSAS patents may be caused by repetitive apneas and hypoxemia during sleep.
Przybyłowski
Tadeusz
T
Katedra i Klinika Chorób Wewnetrznych, Pneumonologii i Alergologii, AM w Warszawie. przyb@amwaw.edu.pl
Bielicki
Piotr
P
Kumor
Marta
M
Hildebrand
Katarzyna
K
Maskey-Warzechowska
Marta
M
Fangrat
Adam
A
Górska
Katarzyna
K
Korczyński
Piotr
P
Chazan
Ryszarda
R
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D011044:Poland / Q000453:epidemiology; D017286:Polysomnography; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012016:Reference Values; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000378:metabolism; D018709:Statistics, Nonparametric
D015415:Biomarkers; D009569:Nitric Oxide