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

Abstract

BackgroundReduced plasma nitrate (NOx) 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 NOx 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.MethodsWe undertook a prospective study of 67 consecutive OSA patients (36 mild-moderate, 31 severe). Measurements of plasma NOx 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.ResultsAt baseline, NOx 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 NOx levels and a reduction in U-NE level and BP only in patients with severe OSA.ConclusionsOne month of CPAP results in significant improvements in NOx levels, 24-h U-NE level and BP in patients with severe OSA, but not in patients with mild-moderate OSA.Trial registrationClinicalTrials.gov: http://NCT01769807

Eight Hours of Nightly Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Patients with Prediabetes. A Randomized Controlled Trial

“…We have found that CPAP treatment decreased norepinephrine levels, which is in agreement with prior reports (25,(44)(45)(46)(47). The magnitude of decrease in norepinephrine levels after CPAP treatment was approximately 27% in our study, which is similar to the 26% reduction observed in earlier studies (47,48).…”

The Prevalence and Clinical Features of Hypertension in Patients With Obstructive Sleep Apnea Hypopnea Syndrome and Related Nursing Strategies

“…Furthermore, continuous positive airway pressure (CPAP) therapy was shown to be effective in preventing the transitory increase in BP (Stergiou et al, 2013). CPAP resulted in significant improvements in 24-hour urinary norepinephrine levels and BP in patients with severe OSAHS (Pinto et al, 2013).…”

Obstructive Sleep Apnea and Hypertension

“…21 Effective OSA treatment with CPAP reduces urinary catecholamine levels, 22 and this reduction seems to be especially evident in patients with more severe OSA. 23 Animal studies suggest that renal denervation attenuates the BP rise associated with OSA events. 24 Autonomic ganglia-mediated changes in cardiac arrhythmogenicity related to OSA are discussed in sections below.…”