Effects of CPAP on nitrate and norepinephrine levels in severe and mild-moderate sleep apnea

Paula Pinto, Cristina Bárbara, Joseph M Montserrat, Rita S Patarrão, Maria P Guarino, Miguel M Carmo, Maria P Macedo, Cristina Martinho, Rita Dias, Maria J M Gomes, Paula Pinto, Cristina Bárbara, Joseph M Montserrat, Rita S Patarrão, Maria P Guarino, Miguel M Carmo, Maria P Macedo, Cristina Martinho, Rita Dias, Maria J M Gomes

Abstract

Background: Reduced plasma nitrate (NO(x)) levels and increased urinary norepinephrine (U-NE) levels have been described in severe obstructive sleep apnea (OSA), and are reverted by continuous positive airway pressure (CPAP). The effect of CPAP on these biomarkers in mild-moderate OSA is not well understood. The aim of this study was to compare NO(x) and U-NE levels and blood pressure (BP) between male patients with mild-moderate and severe OSA and determine the impact of 1 month of CPAP therapy on these parameters.

Methods: We undertook a prospective study of 67 consecutive OSA patients (36 mild-moderate, 31 severe). Measurements of plasma NO(x) at 11 pm, 4 am and 7 am, 24-h U-NE and ambulatory BP were obtained at baseline and after 1 month of CPAP.

Results: At baseline, NO(x) levels showed a significant decrease during the night in both groups (p < 0.001). U-NE level and BP were significantly higher in the severe OSA group. After 1 month of CPAP, there was a significant increase in NO(x) levels and a reduction in U-NE level and BP only in patients with severe OSA.

Conclusions: One month of CPAP results in significant improvements in NO(x) levels, 24-h U-NE level and BP in patients with severe OSA, but not in patients with mild-moderate OSA.

Trial registration: ClinicalTrials.gov: NCT01769807.

Figures

Figure 1
Figure 1
NOx levels at different time points before and after 1 month of CPAP in patients with mild-moderate and severe OSA.
Figure 2
Figure 2
U-NE levels before and after 1 month of CPAP in patients with mild-moderate and severe OSA.

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Source: PubMed

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