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Snoring as a Determinant Factor of Oxidative Stress in the Airway of Patients with Obstructive Sleep Apnea

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Abstract

Purpose

In obstructive sleep apnea–hypopnea syndrome (OSAS), airway collapses and vibrations cause local and systemic inflammatory response and oxidative stress (OS). Our objective was to determine the presence of OS in the airway of patients with OSAS compared with controls without OSAS and determine its relation to treatment with CPAP and other clinical variables.

Method

We performed a prospective observational case–control study with repeated measures. We recruited consecutive patients with SAHS diagnosed using complete polysomnography, and a parallel control group. We collected a sample of exhaled breath condensate (EBC) prior to nasal continuous positive airway pressure (CPAP) treatment and again after 4 months. The marker of OS used was 8-isoprostane (8-IPN). The variables analyzed were age, sex, anthropometric variables, apnea–hypopnea index (AHI), snoring, oxygenation, and polysomnographic variables.

Results

The study included 20 patients and 10 controls. In cases, the initial value of 8-IPN was 6.8 (1.9), and after nasal CPAP, it was 5.3 (1.2) pg/ml (p = 0.02). In controls, the value of 8-IPN was 5.6 (1.1) pg/ml (p = 0.04 compared to initial values). 8-IPN showed significant correlation with snoring, AHI, BMI, nocturnal desaturation index, and non-REM sleep. On multivariate analysis, only snoring was a significant predictor of 8-IPN.

Conclusions

Snoring, and not OSAS severity, could be the phenomenon underlying the presence of local OS measured in the airway of patients with OSAS.

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Acknowledgments

This study was funded by the Asturian Respiratory Society (ASTURPAR) with a research grant for the determination of 8-isoprostane.

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Authors and Affiliations

  1. Servicio de Neumologia, Área de gestión de Pulmón, Hospital Universitario Central de Asturias, C/Joaquin Alonso Bonet nº 6 5º izda, 33206, Oviedo, Gijón, Asturias, Spain

    Ramon Fernandez Alvarez, Juan Alejandro Cascon Hernandez, Begoña Palomo Antequera, Marta Iscar Urrutia & Pere Casan Clara

  2. Servicio de Inmunologia, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain

    Gemma Rubinos Cuadrado & Rebeca Alonso Arias

Authors
  1. Ramon Fernandez Alvarez
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  2. Gemma Rubinos Cuadrado
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  3. Rebeca Alonso Arias
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  4. Juan Alejandro Cascon Hernandez
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  5. Begoña Palomo Antequera
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  6. Marta Iscar Urrutia
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  7. Pere Casan Clara
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Corresponding author

Correspondence to Ramon Fernandez Alvarez.

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Conflict of Interest

None.

Ethical Approval

The study was approved by the Clinical Research Ethics Committee of our hospital.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Fernandez Alvarez, R., Rubinos Cuadrado, G., Alonso Arias, R. et al. Snoring as a Determinant Factor of Oxidative Stress in the Airway of Patients with Obstructive Sleep Apnea. Lung 194, 469–473 (2016). https://doi.org/10.1007/s00408-016-9869-0

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  • DOI: https://doi.org/10.1007/s00408-016-9869-0

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