title: Nitric oxide and obstructive sleep apnea.
abstract: Obstructive sleep apnea is a common disease, affecting 16% of the working age population. Although sleep apnea has a well-established connection to daytime sleepiness presumably mediated through repetitive sleep disruption, some other consequences are less well understood. Clinical, epidemiological, and physiological investigations have demonstrated a connection between sleep apnea and daytime hypertension. The elevation of arterial pressure is evident during waking, when patients are not hypoxic, and is mediated by sustained sympathoexcitation and by altered peripheral vascular reactivity. This review summarizes data suggesting that both the sympathoexcitation and the altered vascular reactivity are, at least in part, a consequence of reduced expression of nitric oxide synthase, in neural tissue and in endothelium. Reduced nitric oxide generation in central and peripheral sites of sympathoregulation and in endothelium together may, in part, explain the elevations in waking pressures observed in sleep apnea patients.
authors.affiliation: Division of Pulmonary, Critical Care, & Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States. jweiss@bidmc.harvard.edu
authors.forename: J Woodrow
authors.initials: JW
authors.lastname: Weiss
authors.forename: Yuzhen
authors.initials: Y
authors.lastname: Liu
authors.forename: Xianghong
authors.initials: X
authors.lastname: Li
authors.forename: En-sheng
authors.initials: ES
authors.lastname: Ji
mesh_terms: D000818:Animals; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D009129:Muscle Tonus / Q000502:physiology; D009131:Muscle, Smooth, Vascular / Q000502:physiology; D009569:Nitric Oxide / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology
chemical_list: D009569:Nitric Oxide