Effects of CPAP on oxidative stress and nitrate efficiency in sleep apnoea: a randomised trial

Alonso-Fernández, Alberto; García‐Río, Francisco; Arias, Miguel Á.; Hernánz, Ángel; Peña, Mónica de la; Piérola, Javier; Barceló, Antònia; López-Collazo, Eduardo; Agustí, Àlvar

doi:10.1136/thx.2008.100537

Cited by 166 publications

(115 citation statements)

References 38 publications

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“…However, most clinical research has studied the correlation of this impact via therapeutic interventions without analyzing causality (10,25,26). Other studies have shown improvements in oxidative stress with CPAP treatment (7,(27)(28)(29)(30). Recently, our group has observed an increase in MDA in OSA patients with greater desaturation, although this increase was not related to worsening of endothelial function (16).…”

Section: Discussionmentioning

confidence: 82%

Association of Cellular Adhesion Molecules and Oxidative Stress with Endothelial Function in Obstructive Sleep Apnea

et al. 2012

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Objective To evaluate the impact of oxidative stress and cellular adhesion molecules on ischemic reactive hyperemia (IRH) in patients with OSA. Materials and MethodsConsecutive patients treated at a sleep laboratory and whose polysomnography showed an apnea hypopnea index (AHI) " 5 were included in the study. Patients with acute illness receiving vasoactive medications were excluded. Based on their oxygen desaturation index (ODI), subjects were assigned to the mild-moderate (ODI !30) or the severe desaturation group (ODI >30). Then IRH and oxidative stress markers [malondialdehyde (MDA)] and proinflammatory markers (ICAM-1 and P-selectin) were measured. Results Sixty-eight subjects with OSA were included, 31 in the mild-moderate desaturation group and 37 in the severe group. No differences by age, gender and body mass index were observed. The severe desaturation group showed significantly higher values in the AHI, MDA, ICAM-1 and P-selectin (p<0.005), as well as a worsening of IRH (p=0.001). Only ICAM-1 (p=0.019) and P-selectin (p=0.033) were independently associated with IRH in a multiple-linear regression model. Conclusion Patients with OSA and greater intermittent hypoxia showed worse endothelial function, and higher levels of MDA, ICAM-1 and P-selectin. Nevertheless, ICAM-1 and P-selectin rather than MDA were independently associated with IRH.

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Section: Discussionmentioning

confidence: 82%

Association of Cellular Adhesion Molecules and Oxidative Stress with Endothelial Function in Obstructive Sleep Apnea

et al. 2012

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“…In previous studies, improvement in endothelial dysfunction was observed in response to CPAP treatment [11,23,24,28,29]. It is also postulated that CPAP can alleviate oxidative stress [11,30]. CARPAGNANO et al [31] showed that an increase in 8-isoprostane in exhaled breath condensate, which decreased significantly after CPAP treatment.…”

Section: Discussionmentioning

confidence: 99%

Relationship of oxidative stress and endothelial dysfunction in sleep apnoea

Jurado-Gámez

Fernandez-Marin²,

Gomez-Chaparro³

et al. 2010

Eur Respir J

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The aim of the present study was to evaluate ischaemic reactive hyperaemia (IRH) in obstructive sleep apnoea (OSA) and its relationship with oxidative stress.We studied 69 consecutive patients referred to our Sleep Unit (Reina Sofia University Hospital, Cordoba, Spain). Patients with chronic diseases or those taking medication were excluded. IRH was assessed before and after polysomnography. Morning IRH and oxidative stress markers were compared between patients with (apnoea-hypopnoea index (AHI) o5) and without (AHI ,5) OSA. Measurements were repeated in 25 severe OSA patients after continuous positive airway pressure (CPAP) therapy.We included 46 OSA patients (mean¡SD AHI 49¡32.1) and 23 non-OSA subjects (AHI 3¡0.9). The OSA patients showed a significant worsening of morning IRH, and a significant increase in malondialdehyde and 8-hydroxydeoxyguanosine levels. Only the oxygen desaturation index independently explained morning IRH, while malondialdehyde levels showed a weak effect on IRH. In severe OSA patients, IRH improved significantly after CPAP treatment, as did malondialdehyde, 8-hydroxydeoxyguanosine and protein carbonyl levels.In OSA patients, endothelial dysfunction and oxidative stress were observed, and IRH worsened after sleep. The increase in oxidative stress was not associated with IRH, while intermittent hypoxia was strongly associated with IRH. In severe OSA patients, CPAP treatment improved oxidative stress and endothelial function.

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“…In patients with OSA, CPAP therapy has been proven to reduce markers of oxidative stress in a randomised-controlled trial [39].…”

Section: +mentioning

confidence: 99%

Effects of obstructive sleep apnoea on heart rhythm

2012

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Symptomatic obstructive sleep apnoea (OSA) has been proven to be a risk factor for hypertension and vascular dysfunction, and has been proposed to be causally related with cardiac arrhythmias and sudden cardiac death.Searches of bibliographical databases revealed that several mechanisms seem to underpin the association between OSA and cardiac arrhythmias: intermittent hypoxia associated with autonomic nervous system activation and increased oxidative stress, which may lead to cardiac cellular damage and alteration in myocardial excitability; recurrent arousals, resulting in sympathetic activation and coronary vasoconstriction; and increased negative intrathoracic pressure which may mechanically stretch the myocardial walls and, thus, promote acute changes in myocardial excitability as well as structural remodelling of the myocardium.Findings from cross-sectional studies suggest a high prevalence of cardiac arrhythmias in patients with OSA and a high prevalence of OSA in those with cardiac arrhythmias. Preliminary evidence from uncontrolled interventional studies suggests that treatment of OSA may prevent cardiac arrhythmias.In conclusion, there is preliminary evidence that OSA is associated with the development of cardiac arrhythmias. Data from randomised controlled studies are needed to definitively clarify the role of OSA in arrhythmogenesis.

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Effects of CPAP on oxidative stress and nitrate efficiency in sleep apnoea: a randomised trial

Cited by 166 publications

References 38 publications

Association of Cellular Adhesion Molecules and Oxidative Stress with Endothelial Function in Obstructive Sleep Apnea

Association of Cellular Adhesion Molecules and Oxidative Stress with Endothelial Function in Obstructive Sleep Apnea

Relationship of oxidative stress and endothelial dysfunction in sleep apnoea

Effects of obstructive sleep apnoea on heart rhythm

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