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Oxidative stress in patients with obstructive sleep apnea syndrome

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Abstract

Purpose

We aimed to investigate whether systemic oxidative stress is increased in patients with obstructive sleep apnea syndrome (OSAS).

Methods

A total of 18 patients with severe OSAS and 13 controls were included in the study. Inclusion criteria for OSAS patients were: snoring and apnea–hypopnea index (AHI) of >30 in full polysomnography, no previous treatment for OSAS, non-smoking status, and a medical history of being free of comorbidities known to increase oxidative stress. Controls were recruited among subjects assessed for snoring in the Sleep Laboratory Department if they had AHI<5. At baseline, patients were evaluated by the Epworth Sleepiness Scale and underwent spirometry, echocardiography, and full polysomnographic study. Blood samples were collected for evaluation of oxidative stress biomarkers [protein carbonyls, reduced (GSH) and oxidized (GSSG) glutathione, 8-isoprostane, thiobarbituric acid-reactive substances (TBARS), catalase activity, Cu–Zn superoxide dysmutase (SOD), total antioxidant capacity (TAC)] before and on the morning following polysomnography.

Results

The overnight (morning–night) change (%) of GSH/GSSG ratio and GSH was significantly different between OSAS and controls (p = 0.03 and p = 0.048, respectively). Plasma protein carbonyls, erythrocyte catalase activity, 8-isoprostane, SOD, TBARS, and TAC plasma values were not different between OSAS and controls (p > 0.05). No significant correlation was found between changes in the levels of biomarkers and AHI, arousal, or desaturation index.

Conclusion

The present prospective investigation in a population free of comorbidities or factors which may increase systemic oxidative stress provides evidence that obstructive sleep apnea per se might be associated with increased oxidative burden possibly via GSH/GSSG pathway.

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Abbreviations

AHI:

Apnea–hypopnea index

AI:

Apnea index

EF:

Ejection fraction

FEV1:

Forced expiratory volume in the first minute

FVC:

Forced vital capacity

GSH:

Reduced glutathione

GSSG:

Oxidized glutathione

HDL:

High-density lipoprotein

K2EDTA:

Dipotassiumethylenediaminetetraacetic acid

LDL:

Low-density lipoprotein

OSAS:

Obstructive sleep apnea syndrome

PSM:

Polysomnography

SaO2 :

Oxygen saturation

SOD:

Cu–Zn superoxide dysmutase

TAC:

Total antioxidant capacity

TBARS:

Thiobarbituric acid-reactive substances

TCA:

Trichloroacetic acid

TG:

Triglycerides

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Cardiology, University Hospital of Thessaly Biopolis, Larissa, 41110, Greece

    Melpomeni Ntalapascha

  2. Intensive Care Department, University Hospital of Thessaly Biopolis, Larissa, 41110, Greece

    Demosthenes Makris & Epaminondas Zakynthinos

  3. Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, 41221, Greece

    Antonis Kyparos & Dimitrios Kouretas

  4. Department of Pneumonology, University Hospital of Thessaly Biopolis, Larissa, 41110, Greece

    Irene Tsilioni, Konstantinos Kostikas & Konstantinos Gourgoulianis

Authors
  1. Melpomeni Ntalapascha
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  2. Demosthenes Makris
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  4. Irene Tsilioni
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  5. Konstantinos Kostikas
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  6. Konstantinos Gourgoulianis
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Correspondence to Demosthenes Makris.

Additional information

Part of the results which are included in the present manuscript has been presented in the form of an abstract at the ERS Berlin 2008 Congress.

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Ntalapascha, M., Makris, D., Kyparos, A. et al. Oxidative stress in patients with obstructive sleep apnea syndrome. Sleep Breath 17, 549–555 (2013). https://doi.org/10.1007/s11325-012-0718-y

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  • DOI: https://doi.org/10.1007/s11325-012-0718-y

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