Endothelial function in patients with post-CPAP residual sleepiness.
OBJECTIVE
The significance of residual excessive daytime sleepiness (EDS) on cardiovascular markers in patients with adequately treated obstructive sleep apnea (OSA) remains unclear. The objective of this study was to investigate flow-mediated dilatation (FMD) and inflammatory markers (C-reactive protein [CRP], tumor necrosis factor [TNF]-alpha, and interleukin [IL]-6) in continuous positive airway pressure (CPAP)-compliant patients with residual EDS compared with CPAP-compliant patients without residual EDS.


METHODS
FMD of the brachial artery was measured by ultrasound in 12 CPAP-compliant patients with OSA who had residual EDS and 12 age-, sex-, and body mass index-matched CPAP-compliant patients with OSA who did not have residual EDS on week 8 after initiation of CPAP. Twelve otherwise-healthy subjects without sleep disordered breathing were used as control subjects. Serum concentrations of CRP, TNF-alpha, and IL-6 were quantified by enzyme-linked immunosorbent assays.


RESULTS
Baseline FMD was comparable among CPAP-compliant patients with residual EDS (7.2 +/- 2.3), CPAP-compliant patients without residual EDS (8.6 +/- 2.1), and control subjects (7.7 +/- 1.4) (p = 0.37). The concentrations of CRP, TNF-alpha, and IL-6 were also not significantly different between subjects with CPAP-compliant residual EDS and those without residual EDS (p = 0.44, p = 0.37, and p = 0.42; respectively).


CONCLUSIONS
Residual EDS in patients with adequately treated OSA may not represent a risk factor for cardiovascular diseases.
El-Solh
Ali A
AA
The Veterans Affairs Western New York Healthcare System, Buffalo, NY 14215-1199, USA. solh@buffalo.edu
Akinnusi
Morohunfolu E
ME
Moitheennazima
Binusha
B
Ayyar
Lakshmy
L
Relia
Sachin
S
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging; D002097:C-Reactive Protein / Q000378:metabolism; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006970:Disorders of Excessive Somnolence / Q000097:blood* / Q000150:complications; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D015588:Observer Variation; D017286:Polysomnography / Q000379:methods; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014463:Ultrasonography
D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein