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Relationship with excessive daytime sleepiness and serum substance P levels in OSAS patients and the effect of PAP treatment

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Abstract

Obstructive sleep apnea syndrome (OSAS) is a commonly seen disorder characterized by repeated episodes of upper airway obstruction during sleep leading to intermittent hypoxemia or arousal. We aim to evaluate the effects of positive airway pressure (PAP) treatment on daytime sleepiness and serum Substance P (SP) levels in OSAS patients. Seventy-one consecutive patients with newly diagnosed OSAS and 19 non-apneic control subjects were enrolled to the study. PAP treatment indicated subjects were re-evaluated after 3 months of treatment. Morning SP levels of OSAS patients and Epworth sleepiness scale (ESS) were assessed at the beginning and then after 3 months of PAP treatment. Of the patients 71 (78.9%) were male and 19 (21.1%) were female, with a median age of 45 [20–62]. The levels of SP in the OSAS group were significantly lower than the snorer group and a significant correlation was not found between serum levels of SP and ESS. SP levels were negatively correlated with AHI. The baseline SP median was 336.1 pg/mL [121.6–536.1], while the 3rd month SP median was 213.1 pg/mL [103.5–727.6]. Serum SP values were found to have significantly decreased at 3 months (p < 0.0001). Statistically significant correlation was not found between percentage of ESS change and the percentage of SP change. It can be assumed that the SP level is reduced as part of the compensation mechanism in OSAS cases and supporting this mechanism, the PAP therapy further reduces the SP value by relieving the cases from apnea and the intermittent hypoxia burden.

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Abbreviations

AHI:

Apnea-hypopnea index

APAP:

Auto-CPAP

BBB:

Blood–brain barrier

BMI:

Body mass index

BPAP:

Bilevel positive airway pressure

CIH:

Chronic intermittent hypoxia

CPAP:

Continuous positive airway pressure

CSF:

Cerebrospinal fluid

EDS:

Excessive daytime sleepiness

ESS:

Epworth sleepiness scale

NKA:

Neurokinin A

NKB:

Neurokinin B

NREM:

Non-rapid eye movement

OSAS:

Obstructive sleep apnea syndrome

PAP:

Positive airway pressure

PSG:

Polysomnography

REM:

Rapid eye movement

SP:

Substance P

TST:

Total sleep time

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Department of Pulmonary Diseases, Uludag University Faculty of Medicine, Görükle, 16059, Bursa, Turkey

    Ozge Aydin Guclu, Ahmet Ursavas & Mehmet Karadag

  2. Department of Otolaryngology, Uludag University Faculty of Medicine, Bursa, Turkey

    Fikret Kasapoglu

  3. Department of Medical Biochemistry, Uludag University Faculty of Medicine, Bursa, Turkey

    Yesim Ozarda & Cengiz Bozyigit

  4. Department of Biostatistics, Uludag University Faculty of Medicine, Bursa, Turkey

    Gökhan Ocakoglu

Authors
  1. Ozge Aydin Guclu
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  2. Ahmet Ursavas
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  3. Fikret Kasapoglu
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  4. Yesim Ozarda
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  5. Cengiz Bozyigit
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  6. Gökhan Ocakoglu
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  7. Mehmet Karadag
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Contributions

We would like to acknowledge all participants who contributed their data to this research. All authors approved the final version of the manuscript. We would like to express our sincere gratitude to Aslı Görek Dilektaşlı and Ezgi Demirdöğen Çetinoğlu for their significant intellectual contribution.

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Correspondence to Ozge Aydin Guclu.

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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.

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Aydin Guclu, O., Ursavas, A., Kasapoglu, F. et al. Relationship with excessive daytime sleepiness and serum substance P levels in OSAS patients and the effect of PAP treatment. Sleep Biol. Rhythms 17, 355–361 (2019). https://doi.org/10.1007/s41105-019-00217-0

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