Sleepiness, inflammation and oxidative stress markers in middle-aged males with obstructive sleep apnea without metabolic syndrome: a cross-sectional study

• Published in: Respiratory research 2015-01, Vol.16 (1), p.3-3, Article 3
• Main Authors: Andaku, Daniela Kuguimoto, D'Almeida, Vânia, Carneiro, Gláucia, Hix, Sônia, Tufik, Sergio, Togeiro, Sônia Maria
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Biomarkers - blood; C-reactive protein; C-Reactive Protein - analysis; Case-Control Studies; Complications and side effects; Cross-Sectional Studies; Diagnosis; Disorders of Excessive Somnolence - blood; Disorders of Excessive Somnolence - diagnosis; Disorders of Excessive Somnolence - physiopathology; Humans; Inflammation; Inflammation - blood; Inflammation - diagnosis; Inflammation Mediators - blood; Male; Middle Aged; Oxidative Stress; Phenotype; Physiological aspects; Risk factors; Sex Factors; Sleep; Sleep apnea syndromes; Sleep Apnea, Obstructive - blood; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - physiopathology; Up-Regulation
• ISSN: 1465-993X; 1465-9921; 1465-993X
• DOI: 10.1186/s12931-015-0166-x

The simultaneous occurrence of metabolic syndrome and excessive daytime sleepiness are very common in obstructive sleep apnea (OSA) patients. Both conditions, if present in OSA, have been reported to be associated with inflammation and disruption of oxidative stress balance that impair the cardiovascular system. To verify the impact of daytime sleepiness on inflammatory and oxidative stress markers, we evaluated OSA patients without significant metabolic disturbance. Thirty-five male subjects without diagnostic criteria for metabolic syndrome (Adult Treatment Panel III) were distributed into a control group (n = 10) (43 ± 10.56 years, apnea-hypopnea index - AHI 2.71 ± 1.48/hour), a non-sleepy OSA group (n = 11) (42.36 ± 9.48 years, AHI 29.48 ± 22.83/hour) and a sleepy OSA group (n = 14) (45.43 ± 10.06 years, AHI 38.20 ± 25.54/hour). Excessive daytime sleepiness was considered when Epworth sleepiness scale score was ≥ 10. Levels of high-sensitivity C-reactive protein, homocysteine and cysteine, and paraoxonase-1 activity and arylesterase activity of paraoxonase-1 were evaluated. Patients with OSA and excessive daytime sleepiness presented increased high-sensitivity C-reactive protein levels even after controlling for confounders. No significant differences were found among the groups in paraoxonase-1 activity nor arylesterase activity of paraoxonase-1. AHI was independently associated and excessive daytime sleepiness tended to have an association with high-sensitivity C-reactive protein. In the absence of metabolic syndrome, increased inflammatory response was associated with AHI and daytime sleepiness, while OSA was not associated with abnormalities in oxidative stress markers.