Abstract
Purpose
The purpose of this study was to examine the effects of one night of continuous positive airway pressure (CPAP) therapy on oxidative stress (lipid peroxidation) levels and the antioxidant activities of superoxide dismutase (SOD) in hypertensive patients with severe obstructive sleep apnea (OSA).
Methods
The study group consisted of 34 hypertensive, non-smoking patients with a mean age of 45.09 ± 11.77 years, body mass index of 37.4 ± 8.4 kg/m2, apnea hypopnea index of 79.17 ± 31.35/h, and desaturation index of 55.07 ± 27.06/h. Patients included in the study were not on medications that may affect antioxidant activity. Patients spent four nights in the sleep disorder center as follows: night 1, an adaptation night; night 2, a diagnostic night; night 3, CPAP titration night; and night 4, a therapeutic night for CPAP treatment. Blood samples were collected in the morning upon awakening on nights 2 and 4 and were immediately transferred to the laboratory for SOD and lipid peroxidation measurements. Oxidative stress levels were quantified by measuring thiobarbituric acid reactive substances. SOD enzymatic activity was measured using a purely chemical system based on NAD(P)H oxidation.
Results
Mean SOD concentrations were not significantly different in pre-and post-CPAP treatment (0.22 ± 0.09 vs. 0.22 ± 0. U/ml, respectively). However, CPAP treatment significantly inhibited lipid peroxidation levels (2.81 ± 0.27 vs. 2.47 ± 0.35 mmol/ml, respectively, p < 0.005).
Conclusion
The present study supports the theory that CPAP therapy decreases the levels of oxidative stress in OSA patients but may not affect antioxidant defense.
Similar content being viewed by others
References
Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research (1999) The report of an American academy of sleep medicine task force. Sleep 22(5):667–689
Selim B, Won C, Yaggi HK (2010) Cardiovascular consequences of sleep apnea. Clin Chest Med 31(2):203–220
Christou K, Moulas AN, Pastaka C, Gourgoulianis KI (2003) Antioxidant capacity in obstructive sleep apnea patients. Sleep Med 4(3):225–228
Halliwell B (1993) The role of oxygen radicals in human disease, with particular reference to the vascular system. Haemostasis 23(Suppl 1):118–126
Mugge A (1998) The role of reactive oxygen species in atherosclerosis. Z Kardiol 87(11):851–864
Duranteau J, Chandel NS, Kulisz A, Shao Z, Schumacker PT (1998) Intracellular signaling by reactive oxygen species during hypoxia in cardiomyocytes. J Biol Chem 273(19):11619–11624
Shi H (2009) Hypoxia inducible factor 1 as a therapeutic target in ischemic stroke. Curr Med Chem 16(34):4593–4600
Wali SO, Bahammam AS, Massaeli H, Pierce GN, Iliskovic N, Singal PK, Kryger MH (1998) Susceptibility of LDL to oxidative stress in obstructive sleep apnea. Sleep 21(3):290–296
Ozturk L, Mansour B, Yuksel M, Yalcin AS, Celikoglu F, Gokhan N (2003) Lipid peroxidation and osmotic fragility of red blood cells in sleep-apnea patients. Clin Chim Acta 332(1–2):83–88
Alzoghaibi MA, Bahammam AS (2005) Lipid peroxides, superoxide dismutase and circulating IL-8 and GCP-2 in patients with severe obstructive sleep apnea: a pilot study. Sleep Breath 9(3):119–126
Barcelo A, Miralles C, Barbe F, Vila M, Pons S, Agusti AG (2000) Abnormal lipid peroxidation in patients with sleep apnoea. Eur Respir J 16(4):644–647
Lavie L, Vishnevsky A, Lavie P (2004) Evidence for lipid peroxidation in obstructive sleep apnea. Sleep 27(1):123–128
Pepperell JC, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJ (2002) Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 359(9302):204–210
Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, Peter JH (2003) Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 107(1):68–73
Steiropoulos P, Tsara V, Nena E, Fitili C, Kataropoulou M, Froudarakis M, Christaki P, Bouros D (2007) Effect of continuous positive airway pressure treatment on serum cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea syndrome. Chest 132(3):843–851
Dorkova Z, Petrasova D, Molcanyiova A, Popovnakova M, Tkacova R (2008) Effects of continuous positive airway pressure on cardiovascular risk profile in patients with severe obstructive sleep apnea and metabolic syndrome. Chest 134(4):686–692
Imadojemu VA, Gleeson K, Quraishi SA, Kunselman AR, Sinoway LI, Leuenberger UA (2002) Impaired vasodilator responses in obstructive sleep apnea are improved with continuous positive airway pressure therapy. Am J Respir Crit Care Med 165(7):950–953
Ciftci TU, Kokturk O, Bukan N, Bilgihan A (2004) The relationship between serum cytokine levels with obesity and obstructive sleep apnea syndrome. Cytokine 28(2):87–91
Zalba G, San Jose G, Moreno MU, Fortuno MA, Fortuno A, Beaumont FJ, Diez J (2001) Oxidative stress in arterial hypertension: role of NAD(P)H oxidase. Hypertension 38(6):1395–1399
Touyz RM (2004) Reactive oxygen species, vascular oxidative stress, and redox signaling in hypertension: what is the clinical significance? Hypertension 44(3):248–252
Millman RP, Redline S, Carlisle CC, Assaf AR, Levinson PD (1991) Daytime hypertension in obstructive sleep apnea. Prevalence and contributing risk factors. Chest 99(4):861–866
Rechtschaffen A (1968) A manual of standardized terminology, techniques, and scoring system for sleep stages of human subjects. NIH Publication 204, Public Health Service, US Government Printing Office
Bonnet M, Carley D, Carskadon M, Easton P (1992) EEG arousals: scoring rules and examples: a preliminary report from the sleep disorders atlas task force of the American Sleep Disorders Association. Sleep 15(2):173–184
Iber C, Ancoli-Israel S, Chesson AL Jr, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine, Westchester
Jentzsch AM, Bachmann H, Furst P, Biesalski HK (1996) Improved analysis of malondialdehyde in human body fluids. Free Radic Biol Med 20(2):251–256
Paoletti F, Mocali A (1990) Determination of superoxide dismutase activity by purely chemical system based on NAD(P)H oxidation. Methods Enzymol 186:209–220
Garvey JF, Taylor CT, McNicholas WT (2009) Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation. Eur Respir J 33(5):1195–1205
Jelic S, Le Jemtel TH (2008) Inflammation, oxidative stress, and the vascular endothelium in obstructive sleep apnea. Trends Cardiovasc Med 18(7):253–260
Schulz R, Mahmoudi S, Hattar K, Sibelius U, Olschewski H, Mayer K, Seeger W, Grimminger F (2000) Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea. Impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med 162(2 Pt 1):566–570
Svatikova A, Wolk R, Lerman LO, Juncos LA, Greene EL, McConnell JP, Somers VK (2005) Oxidative stress in obstructive sleep apnoea. Eur Heart J 26(22):2435–2439
Carpagnano GE, Kharitonov SA, Resta O, Foschino-Barbaro MP, Gramiccioni E, Barnes PJ (2002) Increased 8-isoprostane and interleukin-6 in breath condensate of obstructive sleep apnea patients. Chest 122(4):1162–1167
Ghiadoni L, Magagna A, Versari D, Kardasz I, Huang Y, Taddei S, Salvetti A (2003) Different effect of antihypertensive drugs on conduit artery endothelial function. Hypertension 41:1281–1286
Saez GT, Tormos C, Giner V, Chaves J, Lozano JV, Iradi A, Redon J (2004) Factors related to the impact of antihypertensive treatment in antioxidant activities and oxidative stress by-products in human hypertension. Am J Hypertens 17(9):809–816
Taddei S, Virdis A, Ghiadoni L, Versari D, Salvetti G, Magagna A, Salvetti A (2003) Calcium antagonist treatment by lercanidipine prevents hyperpolarization in essential hypertension. Hypertension 41(4):950–955
Acknowledgments
This work was supported by a grant from the King Abdulaziz City for Science and Technology (KACST) and the College of Medicine Research Center (CMRC), King Saud University.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Alzoghaibi, M.A., BaHammam, A.S. The effect of one night of continuous positive airway pressure therapy on oxidative stress and antioxidant defense in hypertensive patients with severe obstructive sleep apnea. Sleep Breath 16, 499–504 (2012). https://doi.org/10.1007/s11325-011-0531-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11325-011-0531-z