Nasal continuous positive airway pressure treatment reduces systemic oxidative stress in patients with severe obstructive sleep apnea syndrome.
OBJECTIVE
To evaluate whether nasal continuous positive airway pressure (nCPAP) reduces oxidative stress in patients with severe obstructive sleep apnea (OSA) syndrome.


METHODS
Forty-six patients with severe OSA (AHI> or =30) requiring nasal CPAP treatment and 46 controls (subjects without OSA and with mild OSA as defined by an AHI<15) were enrolled. Oxidative stress was evaluated in blood samples with a commercially available automated spectrophotometric assay (D-ROMs test, Diacron, Grosseto, Italy). Blood samples were collected the evening before (10:00 p.m.) and the morning after (07:00 a.m.) a diagnostic polysomnography. Patients with severe OSA syndrome were subsequently submitted to a second polysomnography with nasal CPAP titration the following night. Using the same schedule we collected blood samples from the patients the morning after the nCPAP titration and after two months of nCPAP treatment.


RESULTS
Patients with severe OSA presented higher levels of oxidative stress than patients with AHI<15 in the evening and in the morning (357.57+/-13.07 UCarr vs. 319.28+/-12.66 UCarr, p=0.038, and 371.83+/-12.83 UCarr vs. 328.09+/-11.76 UCarr, p=0.014, respectively). Patients with severe OSA presented a significant reduction the levels of oxidative stress the morning after the nCPAP titration study (371.83+/-12.83 UCarr vs. 298.21+/-9.62 UCarr, p=0.001) and this reduction was further preserved after a period of two months of nCPAP treatment (293.72+/-6.55 UCarr, p=0.001 vs. baseline). Statistically significant correlations were observed between levels of oxidative stress and nocturnal polysomnography (NPSG) markers as oxygen desaturation index (ODI), arousal index (AI), lowest oxygen saturation of hemoglobin, and mean oxygen saturation of hemoglobin.


CONCLUSIONS
Patients with severe OSA syndrome presented increased systemic oxidative stress. A single night of nCPAP treatment significantly reduced the levels of oxidative stress in patients with severe OSA syndrome, and this reduction was maintained at least after two months of nCPAP treatment.
Christou
Konstantinos
K
Respiratory Medicine Department, University of Thessaly Medical School, University Hospital of Larissa, Larissa 41110, Greece.
Kostikas
Konstantinos
K
Pastaka
Chaido
C
Tanou
Kalliopi
K
Antoniadou
Irene
I
Gourgoulianis
Konstantinos I
KI
D000328:Adult; D045422:Continuous Positive Airway Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006861:Hydrogen Peroxide / Q000097:blood; D008297:Male; D008875:Middle Aged; D009666:Nose; D018384:Oxidative Stress; D017286:Polysomnography; D017382:Reactive Oxygen Species / Q000097:blood; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000378:metabolism* / Q000628:therapy*; D016896:Treatment Outcome
D017382:Reactive Oxygen Species; D006861:Hydrogen Peroxide