Influence of CPAP treatment on airway and systemic inflammation in OSAS patients

Karamanli, Harun; Özol, Duygu; Uğur, Kadriye Şerife; Yıldırım, Zeki; Armutçu, Ferah; Bozkurt, Bülent; Yiğitoğlu, Ramazan

doi:10.1007/s11325-012-0761-8

Cited by 71 publications

(53 citation statements)

References 27 publications

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“…22 Additionally, CPAP relieves airway obstruction and hypoxia, as well as decrease airway and systemic inflammation and the levels of OSA induced inflammatory mediators. 23 CPAP treatment decreased platelet activation. Adenosine diphosphate-induced platelet aggregability increased significantly in patients with moderate-to-severe OSA compared to that in controls; CPAP treatment improves platelet aggregability in these patients.…”

Section: Discussionmentioning

confidence: 90%

Complete Blood Count Alterations after Six Months of Continuous Positive Airway Pressure Treatment in Patients with Severe Obstructive Sleep Apnea

Sökücü

Özdemir

Dalar

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: The cardiovascular complications caused by obstructive sleep apnea (OSA) decrease after continuous positive airway pressure treatment (CPAP). Mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are newly recognized tools for assessing cardiovascular risk. Methods: From a selection of patients with symptoms of nocturnal snoring and/or excessive daytime sleepiness, 36 males with an apnea-hypopnea index (AHI) > 30/h and 22 age-matched normal male controls with AHI < 5/h were included. Patients with OSA underwent another night of CPAP titration, and 11 patients were excluded at the 6-month evaluation due to poor compliance with the home CPAP therapy. Complete blood count parameters of compliant patients and the control group were evaluated. S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is characterized by collapse of the upper airway during sleep, recurring apnea, intermittent hypoxemia, and daytime sleepiness. The severity of OSA is evaluated in terms of the number of apnea/hypopnea episodes per hour of sleep and is expressed as the apnea-hypopnea index (AHI). 1Red blood cell distribution width (RDW) is a numerical measure of the size variability of circulating erythrocytes and is routinely reported as a component of the complete blood count in the differential diagnosis of anemia. Disorders related to ineffective erythropoiesis or increased red blood cell destruction cause greater size heterogeneity and thus a higher RDW. 2,3Several studies have reported increased platelet activation and aggregation in patients with OSA. 4,5 It has been shown that platelet size, as measured by mean platelet volume (MPV), correlates with platelet reactivity, and is regarded as an easy and useful tool for indirect monitoring of platelet activity. As larger platelets have greater thrombotic potential, the RDW, MPV, and platelet distribution width (PDW) have been shown to be related to cardiovascular morbidity and mortality in patients with cardiac diseases. In OSA patients, RDW, MPV, and PDW are newly recognized indicators of the severity of the condition that are associated with no additional cost compared to a routinely performed complete blood count. 11-14Continuous positive airway pressure (CPAP) therapy is the gold standard in patients with severe OSA. MPV is reduced after CPAP therapy in severe OSA patients, indicating that CPAP therapy has cardioprotective effects. 15 To our knowledge, the effect of CPAP therapy on RDW and PDW in OSA patients has not been reported; thus, we decided to investigate this possibility. BRIEF SUMMARYCurrent Knowledge/Study Rationale: Mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW) are newly recognized tools for assessing cardiovascular risk. These markers increase in patients with OSA. The effect of CPAP treatment on these parameters was evaluated. Study Impact: Our data suggest that complete blood count parameters such as MPV, PDW, and RDW changed ...

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Section: Discussionmentioning

confidence: 90%

Complete Blood Count Alterations after Six Months of Continuous Positive Airway Pressure Treatment in Patients with Severe Obstructive Sleep Apnea

Sökücü

Özdemir

Dalar

et al. 2014

Journal of Clinical Sleep Medicine

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“…CPAP relieves airway obstruction and reduces hypoxia and inflammation [34]. CPAP treatment decreases platelet aggregability [35].…”

Section: Discussionmentioning

confidence: 99%

Effect of Continuous Positive Airway Pressure Treatment on Hemograms of Patients with Severe Obstructive Sleep Apnea in the Lack of Comorbidities

Tapan¹,

Görgülü²,

Tertemiz³

et al. 2017

J Sleep Disord Ther

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In this study, we aimed to evaluate the effect of CPAP treatment on hemograms of patients with severe OSA in the lack of comorbidities which might affect the real values of hematological parameters.This retrospective cohort study patients selected from those whose polysomnography reports were compatible with severe OSAS and who underwent PAP titration in our sleep medicine department. 49 patients were enrolled to the study. The baseline hemograms of the participants were collected from one of the patients' visits before they started to use CPAP devices. The control hemograms were evaluated from one of the control visits in the first six months of treatment. We examined the red cell distribution width (RDW), mean platelet volume (MPV), hemotocrit (Hct) and platelet (Plt) count from the hemograms.The mean age was 58.2 years ± 11.3 years, 38.8% were female and 61.2% were male. 69.4% were non-smokers and 30.6% were ex-smokers. The mean body mass index (BMI) was 31.6 ± 5.8 while the mean apnea hypopnea index (AHI) was 50.2 ± 29. The mean duration of CPAP therapy was 4.8 months ± 3.3 months. The mean RDW, MPV, Hct and Plt count values before CPAP treatment were in normal ranges of laboratory tests. All of the values reduced after CPAP therapy but only the decrease in MPV was statistically significant.The reduced values supported that CPAP treatment helped to control hypercoagulability and prevented from cardiovascular disorders in OSAS. Hemogram may be a cheap and easily found laboratory test for monitoring the response to CPAP therapy.

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“…Much evidence demonstrates that treatment of OSA, including CPAP or surgery, can reduce inflammation and oxidative stress. 7,44,45 A recent meta-analysis of 35 studies involving 1,985 patients with OSA also confirmed that CPAP therapy could partially suppress systemic inflammation and there are differences among the various inflammatory markers such as CRP, IL-6, IL-8, and TNF-α. 7 However, CPAP is underused as a therapy for OSA even though investigators have demonstrated that CPAP may reduce the risk of atrial fibrillation or stroke.…”

Section: 9-11mentioning

confidence: 89%

Management and Risk Reduction of Rheumatoid Arthritis in Individuals with Obstructive Sleep Apnea: A Nationwide Population-Based Study in Taiwan

Chen

Chang

et al. 2016

Sleep

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Influence of CPAP treatment on airway and systemic inflammation in OSAS patients

Cited by 71 publications

References 27 publications

Complete Blood Count Alterations after Six Months of Continuous Positive Airway Pressure Treatment in Patients with Severe Obstructive Sleep Apnea

Complete Blood Count Alterations after Six Months of Continuous Positive Airway Pressure Treatment in Patients with Severe Obstructive Sleep Apnea

Effect of Continuous Positive Airway Pressure Treatment on Hemograms of Patients with Severe Obstructive Sleep Apnea in the Lack of Comorbidities

Management and Risk Reduction of Rheumatoid Arthritis in Individuals with Obstructive Sleep Apnea: A Nationwide Population-Based Study in Taiwan

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