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Background: Obstructive sleep apnea syndrome (OSAS) is a common form of sleep disordered breathing. OSAS is associated with the cluster of metabolic abbreations that comprise the metabolic syndrome, including nonalcoholic fatty liver disease. Aims and Objectives: We investigated the effects of OSAS and its treatment with short term nasal continuous positive airway pressure (CPAP) therapy on serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Materials and Methods: We studied 20 adult males and postmenopausal female aged 50-60 years with OSAS. None had hepatitis B antigen or C antibody positive, autoimmune disease, an alcohol intake higher than 20 g/day or on regular use of hepatotoxic drugs. Abdominal ultrasound was done to establish the presence of fatty liver. Serum levels of AST and ALT were determined at baseline and after nasal CPAP treatment. Results: The baseline ALT and AST values were within normal limits. There was no significant change in ALT (25.9 ± 4.7 vs. 26.2 ± 3.4 after CPAP, P > 0.05) and AST (27.5 ± 2.0 vs. 24.6 ± 1.8, P > 0.05) values after one night of CPAP treatment. Conclusion: Serum aminotransferase may have limited use in assessing liver damage in the OSAS patients. Short term CPAP therapy doesn't seem have beneficial effects on serum aminotransferase levels in patients of OSAS.

Background Obstructive sleep apnea (OSA) is characterized by a combination of structural issues in the upper airway and imbalances in the respiratory control system. While numerous studies have linked OSA with obesity, it remains uncertain whether leptin, a hormone associated with fat, plays a role in the functional and anatomical defects that lead to OSA. Therefore, the aim of this study was to investigate whether leptin levels could be used as a predictor of OSA syndrome (OSAS). Methodology A case-control observational study was conducted, enrolling study participants who reported obesity (BMI > 30) within the range of >30 to <35 kg/m 2 , along with a short neck and a history of snoring, excessive daytime drowsiness, fatigue, or insomnia. Leptin levels and fasting blood sugar (FBS) were measured in all individuals. Additionally, the study evaluated the severity of OSAS using indicators such as the STOP BANG scores, apnea-hypopnea index, uvula grade score, and Epworth Sleepiness Scale scores. Results A total of 80 participants (40 cases and 40 controls) were included in the study. The mean leptin and FBS levels were significantly higher in cases compared to controls. Moreover, leptin levels exhibited a significant correlation with the severity indices of OSAS. Conclusion The study findings indicate that individuals with higher leptin levels tend to exhibit more severe OSAS symptoms. Furthermore, these elevated leptin levels contribute to the worsening of various OSA symptoms. Larger controlled studies have suggested that pharmacologically restoring the altered leptin levels may serve as a beneficial adjunct to treatment for alleviating OSAS symptoms.

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Purpose. To investigate whether oral intake of N-acetylcysteine (NAC) is a treatment option in patients with obstructive sleep apnoea syndrome (OSAS).Methods. Twenty patients with OSAS were enrolled in the study. After polysomnography (PSG), they were randomly assigned to receive a placebo (n=10) and NAC (n=10). A repeat PSG was done after the treatment period of 30 days. Fasting venous samples were collected for various biochemical analysis. Results.In the patients of NAC group, compared to their baseline values, slow wave sleep as sleep percent time (27.9±2.7 vs 42.3±4.2; p<0.01) and sleep efficiency (90.8±1.3 vs 94.4±1.5; p<0.05) improved considerably. The apnoea-hypopnoea index (61.2±8.5 vs 43.1±8.6; p<0.05), apnoea related arousals (22.2±7.6 vs 11.6±4.7; p<0.05), longest apnoeic episode duration (seconds) (54.9±7.1 vs 37.8±5.6; p<0.01), oxygen desaturation events per hour (51.8±7.7 vs 37±7.8; p<0.01) and epworth sleepiness score (16.6±0.8 vs 9.2±0.9; p<0.001) decreased significantly. The relative snore time (%) (10.2±2.9 vs 4.9±1.9; p<0.01), number of snore episodes (63.8±23.9 vs 28.2±9.9; p<0.05) and duration of longest snore episode (min) (2.5±0.7 vs 0.6±0.1; p<0.05) also decreased significantly. Such responses were not evident in the placebo group. N-acetylcysteine produced significant decrease in lipid peroxidation and increase in total reduced glutathione. Conclusions.Oral NAC administration appears to have a therapeutic potential in the treatment of OSAS. It is proposed that long-term treatment with NAC in patients with OSAS may reduce their dependency on continuous positive airway pressure therapy.