Sleep and Breathing

, Volume 17, Issue 2, pp 549–555 | Cite as

Oxidative stress in patients with obstructive sleep apnea syndrome

  • Melpomeni Ntalapascha
  • Demosthenes MakrisEmail author
  • Antonis Kyparos
  • Irene Tsilioni
  • Konstantinos Kostikas
  • Konstantinos Gourgoulianis
  • Dimitrios Kouretas
  • Epaminondas Zakynthinos
Original Article



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


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.


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.


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.


Oxidative stress Obstructive sleep apnea syndrome Hypoxia–reoxygenation TBARS GSH GSSG 



Apnea–hypopnea index


Apnea index


Ejection fraction


Forced expiratory volume in the first minute


Forced vital capacity


Reduced glutathione


Oxidized glutathione


High-density lipoprotein


Dipotassiumethylenediaminetetraacetic acid


Low-density lipoprotein


Obstructive sleep apnea syndrome




Oxygen saturation


Cu–Zn superoxide dysmutase


Total antioxidant capacity


Thiobarbituric acid-reactive substances


Trichloroacetic acid




Conflict of interest

The authors declare no conflict of interest.

Supplementary material

11325_2012_718_MOESM1_ESM.doc (34 kb)
ESM 1 (DOC 34 kb)


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Melpomeni Ntalapascha
    • 1
  • Demosthenes Makris
    • 2
    Email author
  • Antonis Kyparos
    • 3
  • Irene Tsilioni
    • 4
  • Konstantinos Kostikas
    • 4
  • Konstantinos Gourgoulianis
    • 4
  • Dimitrios Kouretas
    • 3
  • Epaminondas Zakynthinos
    • 2
  1. 1.Department of CardiologyUniversity Hospital of Thessaly BiopolisLarissaGreece
  2. 2.Intensive Care DepartmentUniversity Hospital of Thessaly BiopolisLarissaGreece
  3. 3.Department of Biochemistry and BiotechnologyUniversity of ThessalyLarissaGreece
  4. 4.Department of PneumonologyUniversity Hospital of Thessaly BiopolisLarissaGreece

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