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The Effects of a Continuous Positive Airway Pressure (CPAP) Therapy on Oxidative Stress in Patients with Obstructive Sleep Apnea

Year 2024, Volume: 45 Issue: 4, 735 - 739, 30.12.2024

Mustafa Murat Öztürk , Muhammet Polat , Yavuz Selim İntepe , Bülent Çiftçi

https://doi.org/10.17776/csj.1522411

Abstract

Obstructive sleep apnea (OSA) is a sleep disorder that is prevalent and can have major health consequences. The primary objective of this study was to determine whether oxidative stress is induced in OSA patients. It was further aimed to assess effectiveness of a continuous positive airway pressure (CPAP) therapy on decreasing total oxidant status (TOS) and total antioxidant status (TAS) in OSA patients. This study included 70 patients with sleep disorders. Considering the apnea-hypopnea index (AHI) score confirmed by polysomnography, the subjects were divided into two groups as OSA patients (n = 35) and control group including patients with simple snoring problem (n = 35). OSA patients received a CPAP therapy for one month. Blood samples were collected from both groups of patients to measure TAS and TOS levels before and after the CPAP therapy. TAS and TOS levels were significantly higher (p < 0.001), whereas minimum oxygen saturation (minSpO2) and mean oxygen saturation (meanSpO2) were significantly lower in the OSA patients in comparison to those in the control group (P < 0.001). Positive correlations were observed between AHI and TAS levels as well as between AHI and TOS levels. Moreover, positive correlations were found between TAS and average stress index (OSI), TOS and OSI, as well as between minSpO2 and meanSpO2. In contrast, negative correlations were observed between AHI and minSpO2 and meanSpO2, and between TAS and OSI, minSpO2 and meanSpO2. One month of CPAP therapy in OSA patients caused a decrease in TAS and TOS levels, and an increase in OSI, minSpO2 and meanSpO2 values (p < 0.001). According to the current study, OSA patients have elevated oxidative stress. One month of CPAP therapy seems to have a positive impact on the antioxidant status remarkably, and led to improvement in oxidative stress.

Keywords

CPAP therapy Obstructive sleep apnea Oxidative stress TAS TOS

Ethical Statement

This research was supported by the Scientific Research Project Fund of Yozgat Bozok University (Project Number: 6601a-SBE/20-384).

Supporting Institution

Yozgat Bozok University Scientific Research Projects Coordination Office

Project Number

6601a-SBE/20-384.

References

  • [1] Senaratna C.V., Perret J.L., Lodge C.J., Lowe A.J., Campbell B.E., Prevalence of obstructive sleep apnea in the general population: A systematic review, Sleep Medicine Reviews, 34 (2017) 70-81.
  • [2] Strange C., Richard C.L., Shan S., Phillips B.A., Kanotra S., A population-based estimate of the health care burden of obstructive sleep apnea using a STOP-BAG questionnaire in South Carolina, Journal of Clinical Sleep Medicine, 17(3) (2021) 367-374.
  • [3] Fiedorczuk P., Stróżyński A., Olszewska E., Is the oxidative stress in obstructive sleep apnea associated with cardiovascular complications? - Systematic Review, Journal of Clinical Medicine, 9(11) (2020) 3734.
  • [4] Cai H., Harrison D.G., Endothelial dysfunction in cardiovascular diseases: the role of oxidant stress, Circulation Research, 87(10) (2000) 840-844.
  • [5] Landmesser U., Harrison D.G., Oxidant stress as a marker for cardiovascular events: Ox marks the spot, Circulation, 104 (2001) 2638-2640.
  • [6] Mathur S., Devaraj S., Jialal I. Accelerated atherosclerosis, dyslipidemia, and oxidative stress in end-stage renal disease, Current Opinion in Nephrology and Hypertension 2002; 11(2)() 141-147.
  • [7] Gozal D., Kheirandish-Gozal L., Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more, American Journal of Respiratory and Critical Care Medicine, 177(4) (2008) 369-375.
  • [8] Suzuki Y.J., Jain V., Park A.M., Day R.M., Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases, Free Radical Biology and Medicine,40(10) (2006) 1683-1692.
  • [9] Maniaci A., Iannella G., Cocuzza S., Vicini C., Magliulo G., Oxidative stress and inflammation biomarker expression in obstructive sleep apnea patients, Journal of Clinical Medicine, 10(2) (2021) 277.
  • [10] Svatikova A., Wolk R., Lerman L.O., Juncos L.A., Greene E.L., Oxidative stress in obstructive sleep apnoea, European Heart Journal, 26(22) (2005) 2435-2439.
  • [11] Lavie L., Oxidative stress - a unifying paradigm in obstructive sleep apnea and comorbidities, Progress in Cardiovascular Diseases, 51(4) (2009) 303-312.
  • [12] Berry R.B., Budhiraja R., Gottlieb D.J., Gozal D., Iber C., American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events, Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine, Journal of Clinical Sleep Medicine, 8(5) (2012) 597-619.
  • [13] Ghiselli A., Serafini M., Natella F., Scaccini C., Total antioxidant capacity as a tool to assess redox status: critical view and experimental data, Free Radical Biology and Medicine, 29(11) (2000) 1106-1114.
  • [14] Erel O., A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation, Clinical Biochemistry, 37(4) (2004) 277-285.
  • [15] Erel O., A novel automated method to measure total antioxidant response against potent free radical reactions, Clinical Biochemistry, 37(2) (2004) 112-119.
  • [16] Badran M., Ayas N., Laher I., Cardiovascular complications of sleep apnea: role of oxidative stress, Oxidative Medicine and Cellular Longevity, (2014) 985258.
  • [17] Kang H.H., Kim I.K., Lee S.H., Total oxidant and antioxidant status in patients with obstructive sleep apnea and the effect of continuous positive airway pressure, Chronobiology in Medicine, 1(3) (2019) 126-129.
  • [18] Alzoghaibi M.A., Bahammam A.S., Lipid peroxides, superoxide dismutase and circulating IL-8 and GCP-2 in patients with severe obstructive sleep apnea: a pilot study, Sleep and Breathing, 9(3) (2005) 119-126.
  • [19] Öztürk L., Mansour B., Yüksel M., Yalçin A.S., Celikoğlu F., Lipid peroxidation and osmotic fragility of red blood cells in sleep-apnea patients, Clinica Chimica Acta, 332 (2003) 83-88.
  • [20] Wali S.O., Bahammam A.S., Massaeli H., Pierce G.N., Iliskovic N., Susceptibility of LDL to oxidative stress in obstructive sleep apnea, Sleep, 21(3) (1998) 290-296.
  • [21] Schulz R., Mahmoudi S., Hattar K., Sibelius U., Olschewski H., Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea, Impact of continuous positive airway pressure therapy, American Journal of Respiratory and Critical Care Medicine,162 (2000) 566-570.
  • [22] Barceló A., Barbé F., de la Peña M., Vila M., Pérez G., Antioxidant status in patients with sleep apnoea and impact of continuous positive airway pressure treatment, The European Respiratory Journal, , 27(4) (2000) 756-760.
  • [23] Stanek A., Brożyna-Tkaczyk K., Myśliński W., Oxidative Stress Markers among Obstructive Sleep Apnea Patients, Oxidative Medicine and Cellular Longevity, (2021) 9681595.
  • [24] Celec P., Jurkovičová I., Buchta R., Bartík I., Gardlí R., Antioxidant vitamins prevent oxidative and carbonyl stress in an animal model of obstructive sleep apnea, Sleep and Breathing,17(2) (2013) 867-871.
  • [25] Karamanlı H., Özol D., Ugur K.S., Yıldırım Z., Armutçu F., Influence of CPAP treatment on airway and systemic inflammation in OSAS patients, Sleep and Breathing, 18(2) (2014) 251-256.

Year 2024, Volume: 45 Issue: 4, 735 - 739, 30.12.2024

Mustafa Murat Öztürk , Muhammet Polat , Yavuz Selim İntepe , Bülent Çiftçi

https://doi.org/10.17776/csj.1522411

Abstract

Project Number

6601a-SBE/20-384.

References

  • [1] Senaratna C.V., Perret J.L., Lodge C.J., Lowe A.J., Campbell B.E., Prevalence of obstructive sleep apnea in the general population: A systematic review, Sleep Medicine Reviews, 34 (2017) 70-81.
  • [2] Strange C., Richard C.L., Shan S., Phillips B.A., Kanotra S., A population-based estimate of the health care burden of obstructive sleep apnea using a STOP-BAG questionnaire in South Carolina, Journal of Clinical Sleep Medicine, 17(3) (2021) 367-374.
  • [3] Fiedorczuk P., Stróżyński A., Olszewska E., Is the oxidative stress in obstructive sleep apnea associated with cardiovascular complications? - Systematic Review, Journal of Clinical Medicine, 9(11) (2020) 3734.
  • [4] Cai H., Harrison D.G., Endothelial dysfunction in cardiovascular diseases: the role of oxidant stress, Circulation Research, 87(10) (2000) 840-844.
  • [5] Landmesser U., Harrison D.G., Oxidant stress as a marker for cardiovascular events: Ox marks the spot, Circulation, 104 (2001) 2638-2640.
  • [6] Mathur S., Devaraj S., Jialal I. Accelerated atherosclerosis, dyslipidemia, and oxidative stress in end-stage renal disease, Current Opinion in Nephrology and Hypertension 2002; 11(2)() 141-147.
  • [7] Gozal D., Kheirandish-Gozal L., Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more, American Journal of Respiratory and Critical Care Medicine, 177(4) (2008) 369-375.
  • [8] Suzuki Y.J., Jain V., Park A.M., Day R.M., Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases, Free Radical Biology and Medicine,40(10) (2006) 1683-1692.
  • [9] Maniaci A., Iannella G., Cocuzza S., Vicini C., Magliulo G., Oxidative stress and inflammation biomarker expression in obstructive sleep apnea patients, Journal of Clinical Medicine, 10(2) (2021) 277.
  • [10] Svatikova A., Wolk R., Lerman L.O., Juncos L.A., Greene E.L., Oxidative stress in obstructive sleep apnoea, European Heart Journal, 26(22) (2005) 2435-2439.
  • [11] Lavie L., Oxidative stress - a unifying paradigm in obstructive sleep apnea and comorbidities, Progress in Cardiovascular Diseases, 51(4) (2009) 303-312.
  • [12] Berry R.B., Budhiraja R., Gottlieb D.J., Gozal D., Iber C., American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events, Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine, Journal of Clinical Sleep Medicine, 8(5) (2012) 597-619.
  • [13] Ghiselli A., Serafini M., Natella F., Scaccini C., Total antioxidant capacity as a tool to assess redox status: critical view and experimental data, Free Radical Biology and Medicine, 29(11) (2000) 1106-1114.
  • [14] Erel O., A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation, Clinical Biochemistry, 37(4) (2004) 277-285.
  • [15] Erel O., A novel automated method to measure total antioxidant response against potent free radical reactions, Clinical Biochemistry, 37(2) (2004) 112-119.
  • [16] Badran M., Ayas N., Laher I., Cardiovascular complications of sleep apnea: role of oxidative stress, Oxidative Medicine and Cellular Longevity, (2014) 985258.
  • [17] Kang H.H., Kim I.K., Lee S.H., Total oxidant and antioxidant status in patients with obstructive sleep apnea and the effect of continuous positive airway pressure, Chronobiology in Medicine, 1(3) (2019) 126-129.
  • [18] Alzoghaibi M.A., Bahammam A.S., Lipid peroxides, superoxide dismutase and circulating IL-8 and GCP-2 in patients with severe obstructive sleep apnea: a pilot study, Sleep and Breathing, 9(3) (2005) 119-126.
  • [19] Öztürk L., Mansour B., Yüksel M., Yalçin A.S., Celikoğlu F., Lipid peroxidation and osmotic fragility of red blood cells in sleep-apnea patients, Clinica Chimica Acta, 332 (2003) 83-88.
  • [20] Wali S.O., Bahammam A.S., Massaeli H., Pierce G.N., Iliskovic N., Susceptibility of LDL to oxidative stress in obstructive sleep apnea, Sleep, 21(3) (1998) 290-296.
  • [21] Schulz R., Mahmoudi S., Hattar K., Sibelius U., Olschewski H., Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea, Impact of continuous positive airway pressure therapy, American Journal of Respiratory and Critical Care Medicine,162 (2000) 566-570.
  • [22] Barceló A., Barbé F., de la Peña M., Vila M., Pérez G., Antioxidant status in patients with sleep apnoea and impact of continuous positive airway pressure treatment, The European Respiratory Journal, , 27(4) (2000) 756-760.
  • [23] Stanek A., Brożyna-Tkaczyk K., Myśliński W., Oxidative Stress Markers among Obstructive Sleep Apnea Patients, Oxidative Medicine and Cellular Longevity, (2021) 9681595.
  • [24] Celec P., Jurkovičová I., Buchta R., Bartík I., Gardlí R., Antioxidant vitamins prevent oxidative and carbonyl stress in an animal model of obstructive sleep apnea, Sleep and Breathing,17(2) (2013) 867-871.
  • [25] Karamanlı H., Özol D., Ugur K.S., Yıldırım Z., Armutçu F., Influence of CPAP treatment on airway and systemic inflammation in OSAS patients, Sleep and Breathing, 18(2) (2014) 251-256.
There are 25 citations in total.

Details

Primary Language English
Subjects Medical Biochemistry - Proteins, Peptides and Proteomics
Journal Section Natural Sciences
Authors

Mustafa Murat Öztürk 0009-0000-9266-8996

Muhammet Polat 0000-0002-9818-8763

Yavuz Selim İntepe 0000-0002-5697-5291

Bülent Çiftçi 0000-0003-2703-3817

Project Number 6601a-SBE/20-384.
Publication Date December 30, 2024
Submission Date July 25, 2024
Acceptance Date December 8, 2024
Published in Issue Year 2024Volume: 45 Issue: 4

Cite

APA Öztürk, M. M., Polat, M., İntepe, Y. S., Çiftçi, B. (2024). The Effects of a Continuous Positive Airway Pressure (CPAP) Therapy on Oxidative Stress in Patients with Obstructive Sleep Apnea. Cumhuriyet Science Journal, 45(4), 735-739. https://doi.org/10.17776/csj.1522411
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