Relationships between oxidative stress and sleep parameters in patients with obstructive sleep apnea syndrome

Abstract

Objective: Oxidative stress is characterized byan imbalance between production and destruction of reactive oxygen species. In our study, we aimed to determine the relationship between the oxidant-antioxidant balance in patients with showing some biochemical factors reflecting the severity of the disease and sleep parameters in patients with Obstructive Sleep Apnea Syndrome (OSAS). Methods: 93 patients were included to the study at the sleep centre, Department of Chest Diseases, Dicle University Hospital. All patients were subjected to all night polysomnography. Serum TOS and TAS levels were measured. Results: The mean age of patients was 47.4±7.2 years. There was not significant between patient and control groups in terms of age, gender, body mass index and frequency of symptoms (p> 0.05).The mean apnea-hypopnea index (AHI) was 25.1units/hour. We found these parameters significant compared with the control group; apnea-hypopnea index, arousal index, oxygen desaturation index, serum total oxidant and serum total antioxidant level (p

Keywords

• Obstructive Sleep Apnea Syndrome, oxidative stress, TAS, TOS.

Obstrüktif uyku apne sendromlu hastalarda uyku parametreleri ile oksidatif stres arasındaki ilişki

Öz

Amaç: Oksidatif stress reaktif oksijen türevlerinin üretimi ve yıkılması arasındaki dengesizlik ile karakterizedir. Çalışmamızda Obstrüktif uyku apne sendromu (OUAS) hastalarında oksidan –antioksidan dengeyi gösteren bazı biyokimyasal faktörlerle hastalığın şiddetini yansıtan uyku parametreleri arasındaki ilişkiyi belirlemeyi amaçladık. Yöntemler: Çalışmaya Dicle Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Uyku merkezinde Polisomnografi kaydı yapılan toplam 93 hasta alındı. Her olgu tüm gece polisomnografi işlemine tabi tutuldu. Serum total oksidan seviyesi (TOS) ve total antioksidan seviyesi (TAS) düzeyleri ölçüldü. Bulgular: Hastaların yaş ortalaması 47,4 ± 7,2 yıldı. Hasta ve kontrol grupları arasında yaş, cins, vücut kitle indeksi ve semptom sıklığı açısından anlamlı fark saptanmadı (p>0,05).Hastaların apne hipopne indeksi (AHİ) ortalaması 25,1 adet/saat idi. Hasta grubunda kontrol grubuna göre anlamlı olarak farklı bulunan parametreler; apne–hipopne indeksi, arrousal indeksi, oksijen desatürasyon indeksi, serum TOS ve serum TAS idi (p

Anahtar Kelimeler

• Obstrüktif Uyku Apne Sendromu, oksidatif stres,TAS, TOS

Kaynakça

1. Gaudette E, Kimoff RJ. Pathophysiology of OSA. Eur Respir Mon 2010;50:31-50.
2. Kuna S, Remmers JE. Anatomy and Physiology of up- per airway obstruction. In: Kryger MH, Roth T, Dement WC (eds). Principles and practice of Sleep Medicine. 3rd edn. Philadelphia: W.B. Saunders Company, 2008:840-58.
3. American Academy of Sleep Medicine. International classificationof sleep disorders. Diagnostic and cod- ing manual (ICSD-3). American Academy of Sleep Medicine. Available at http://www.aasmnet.org. Ac- cessed on 04 April 2014.
4. Kushida CA, Littner MR, Morgenthaler T, et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 2005;28:499-521.
5. Griendling KK, Fitzgerald GA. Oxidative stress and cardiovascular injury. Part I: basic mechanisms and in vivo monitoring of ROS. Circulation 2003;108:1912- 1916.
6. Lena L. Obstructive sleep apnoea syndrome - an oxi- dative stress disorder. Sleep Med Rev 2003;7:35-51.
7. Cofta S, Wysocka E, Piorunek T, et al. Oxidative stress markers in the blood of persons with different stages of obstructive sleep apnea syndrome. J Physiol Phar- macol 2008;59 (Suppl 6):183-190.
8. Droge W. Free radicals in the physiological control of cell function. Physiol Rev 2002;82:47-95.

9. Mooe T, Rabben T, Wiklund U, et al. Sleep-disordered breathing in men with coronary artery disease. Chest 1996;109:659-663.
10. Andreas S, Schulz R, Werner GS, Kreuzer H. Preva- lance of obstructive sleep apnea in patients with coro- nary artery disease. Coron Artery Dis 1996;7:541-545.
11. McNicholas WT. Sleep apnea syndrome. Breathe 2005;1:219-227.
12. Klawe JJ, Laudencka A, Miskowiec I, Tafil-Klawe M. Occurrence of obstructive sleep apnea in a group of shift worked police officers. J Physiol Pharmacol 2005;56:115-117.
13. Tafil-Klawe M, Laudencka A, Klawe JJ, Miskowiec I. Does night work favor sleep-related accidents in po- lice officers? J Physiol Pharmacol 2005;56:223-226.
14. Christou K, Moulas AN, Pastaka C, Gourgoulianis KI. Antioxidant capacity in obstructive sleep apnea pa- tients. Sleep Med 2003;4:225-228.
15. Banerjee D, Brendon J, Yee J, et al. Obesity Hypoven- tilation Syndrome. Chest 2007;131: 1678-1684.
16. Alam I, Lewis K, Stephens JW, Baxter JN. Obesity, metabolic syndrome and sleep apnoea: all proinflam- matory states. Obes Rev 2006;8:119-127.
17. Knutson K, Spiegel K, Penev P et al. The metabolic consequences of sleep deprivation. Sleep Med Rev 2007;11:163-178.
18. Schulz R, Mahmoudi S, Hattar K, et al. Enhanced release of superoxide from polymorphonuclear neu- trophils in obstructive sleep apnea. Am J Respir Crit Care Med 2000;162:566-570.
19. Chorostowska-Wynimko J, Radomska D, Plywac- zewski R, et al. Disturbed angiogenic activity in sera from obstructive sleep apnea patients. J Physiol Phar- macol 2005;56:71-77.
20. Lam J. An Update on Obstructive Sleep Apnea and the Metabolic Syndrome. Curr Opin Pulm Med 2007;13:484-489.
21. Namyslowski G, Scierski W, Mrowka-Kata K, et al. Sleep study in patients with overweight and obesity. J Physiol Pharmacol 2005;56:59-65.
22. Barcelo A, Barbe F, de la Pena M, et al. Antioxidant status in patients with sleep apnoea and impact of continuous positive airway pressure treatment. Eur Respir J 2006;27:756-760.
23. Lavie L, Vishnevsky A, Lavie P. Evidence for lipid peroxidation in obstructive sleep apnea. Sleep 2004; 27:123-128.
24. Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem 2005;38:1103-1111.
25. Erel O. A novel automated direct measurement meth- od for total antioxidant capacity using a new genera- tion, more stable ABTS radical cation. Clin Biochem 2004;37:277-285.