Short-term effects of continuous positive airway pressure on oxidative stress in severe sleep apnea

  • Ľubomíra Tóthová
  • Peter Celec
  • Imrich Mucska
  • Július HodosyEmail author
Sleep Breathing Physiology and Disorders • Original Article



Obstructive sleep apnea (OSA) is associated with oxidative stress that is involved in the pathogenesis of cardiovascular and metabolic complications. The concentrations of salivary markers of oxidative stress in patients with OSA increase considerably during the night. The dynamics is not affected by continuous positive airway pressure (CPAP) in mild to moderate OSA. The aim of this study was to analyze the short-term effects of CPAP on salivary oxidative stress markers in patients with severe OSA.


Salivary samples were collected from 24 patients with apnea-hypopnea index higher than 30 during the first (diagnostic) night, who were treated by CPAP during the second (therapeutic) night.


The salivary markers of oxidative stress (TBARS, AGEs, and AOPP) were higher in the morning after the diagnostic night when compared to the evening concentrations (p < 0.01 for TBARS and p < 0.05 for AGEs and AOPP). Treatment by CPAP significantly decreased the morning concentrations of TBARS, AOPP (p < 0.01 for both), and AGEs (p < 0.05). Also, TBARS and AGEs positively correlated with apnea-hypopnea index (r = 0.48 and 0.49, respectively; p < 0.05). Antioxidant statuss was not affected.


Severe OSA is associated with increased levels of saliva markers for lipid peroxidation, protein oxidative damage, and carbonyl damage. Even short-term CPAP partially prevents oxidative and carbonyl stress during the night and this can be monitored non-invasively using saliva.


Lipid peroxidation Non-invasive monitoring Oxidative damage Salivary biomarkers 


Author contribution

LT - first draft of the manuscript, responsible for the material and method part of the manuscript, interpretation of the oxidative stress markers data and designing the biochemical part of the study.

PC - design of the study, contribution mainly to the result part and discussion of the manuscript.

IM - design of the study and salivary collections, responsible for patients evaluation and polysomnography, informing patients, general conception of the whole study.

JH - ethical committee approval, responsible for introduction part and overall finalizing of the manuscript, data evaluation, and figure plotting.

All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work. All persons designated as authors qualify for authorship, and all those who qualify for authorship are listed.


This contribution is the result of the project implementation, “Development of the Centre of Excellence for Exploitation of Informational Biomacromolecules for Improvement of Quality of Life” project supported by the Research and Development Operational Programe funded by the ERDF (Contract No. ITMS 26240120027).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained for each patient. The study was approved by the local ethics committee (Ethical committee of the University Hospital Bratislava, Slovakia).


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Institute of Molecular Biomedicine, Faculty of MedicineComenius UniversityBratislavaSlovakia
  2. 2.Institute of Physiology, Faculty of MedicineComenius UniversityBratislavaSlovakia
  3. 3.Institute of Pathophysiology, Faculty of MedicineComenius UniversityBratislavaSlovakia
  4. 4.Department of Molecular Biology, Faculty of Natural SciencesComenius UniversityBratislavaSlovakia
  5. 5.University HospitalBratislavaSlovakia

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