Long-Term Continuous Positive Airway Pressure Therapy Normalizes High Exhaled Nitric Oxide Levels in Obstructive Sleep Apnea

Chua, Ai-Ping; Aboussouan, Loutfi S.; Minai, Omar A.; Paschke, Kelly; Laskowski, Daniel; Dweik, Raed A.

doi:10.5664/jcsm.2740

Cited by 36 publications

(40 citation statements)

References 29 publications

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“…Changes in lung function potentially result from nocturnal release of broncho-reactive mediators. Overnight increase in the levels of potentially bronchoconstrictive 8-isoprostane [10] and bronchodilator nitric oxide [11,12] has previously been reported in the exhaled breath samples in OSA subjects and these mediator changes may be responsible for the findings reported in the current study. Another possible explanation is the augmented adrenal-sympathetic tone during the night in OSA patients [13,14,23].…”

Section: Discussionsupporting

confidence: 65%

“…Theoretically, lung function may vary due to two main reasons. On one hand, overnight changes in airway broncho-reactive mediator concentrations were reported and may influence operational lung volumes [8][9][10][11][12]. On the other hand, OSA is associated with increased sympathetic and decreased parasympathetic tone during sleep, especially during apnoeic periods [13][14][15], which may result in alterations in resting bronchial tone [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Overnight Changes in Lung Function of Obese Patients with Obstructive Sleep Apnoea

Kunos

Lázár

Martinovszky

et al. 2016

Lung

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Purpose Obstructive sleep apnoea (OSA) is a prevalent disorder, characterised by collapse of the upper airways during sleep. The impact of sleep-disordered breathing on pulmonary function indices is however currently not well described. The aim of the study was to evaluate diurnal change in lung function indices in a cohort of patients with OSA and relate pulmonary function changes to disease severity. Methods 42 patients with OSA and 73 healthy control subjects participated in the study. Asthma and COPD were excluded in all volunteers following a clinical and spirometric assessment. Spirometry was then performed in all subjects in the evening and the morning following a polysomnography study. Results There was no difference in evening or morning FEV 1 or FVC between patients and control subjects (p [ 0.05). Neither FEV 1 nor FVC changed in control subjects overnight (p [ 0.05). In contrast, FEV 1 significantly increased from evening (2.18/1.54-4.46/L) to morning measurement (2.26/1.42-4.63/L) in OSA without any change in FVC. The FEV 1 increase in OSA was related to male gender, obesity and the lack of treatment with statins or b-blockers (all p \ 0.05). A tendency for a direct correlation was apparent between overnight FEV 1 change and RDI (p = 0.05, r = 0.30).Conclusions Diurnal variations in spirometric indices occur in patients with OSA and FEV 1 appears to increase in subjects with OSA overnight. These changes occur in the absence of change in FVC and are directly related to the severity of OSA. These findings dictate a need to consider time of lung function measurement.

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Overnight Changes in Lung Function of Obese Patients with Obstructive Sleep Apnoea

Kunos

Lázár

Martinovszky

et al. 2016

Lung

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“…In nonasthmatic patients with OSAS, different studies have shown an increase in FeNO attributed to tissue inflammation of the upper airway directly related to the intensity of OSAS. After 1 to 3 months of CPAP therapy, FeNO levels usually normalized 31, 32. Other studies of shorter treatment periods did not found any improvement 33.…”

Section: Discussionmentioning

confidence: 81%

“…Other authors have evaluated the relationship between FeNO and OSAS, and the effects of CPAP therapy on FeNO, with relatively contradictory results 31, 32, 33. In nonasthmatic patients with OSAS, different studies have shown an increase in FeNO attributed to tissue inflammation of the upper airway directly related to the intensity of OSAS.…”

Section: Discussionmentioning

confidence: 99%

“…OSAS is associated with a systemic and local inflammation of the airways, as well as pulmonary vascular changes and release of endothelial factors (such as vascular endothelial growth factor) with proinflammatory effects 40. The use of CPAP reduces inflammation and its mediators 31. Improvement of gastroesophageal reflux may also be accompanied by a reduction in nocturnal asthma symptoms 15.…”

Section: Discussionmentioning

confidence: 99%

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Asthma outcomes improve with continuous positive airway pressure for obstructive sleep apnea

Serrano-Pariente

Plaza

Soriano

et al. 2016

Allergy

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BackgroundContinuous positive airway pressure (CPAP) in asthma patients with concomitant obstructive sleep apnea syndrome (OSAS) seems to have a favorable impact on asthma, but data are inconsistent due to methodological limitations of previous studies.MethodsProspective, multicenter study. We examined asthma outcomes after 6 months of CPAP in 99 adult asthma patients (mean age 57 years) with OSAS (respiratory disturbance index ≥20). Asthma control and quality of life were assessed with the Asthma Control Questionnaire (ACQ) and the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), respectively. Data were analyzed by intention‐to‐treat basis.ResultsThe mean ± SD score of the ACQ decreased from 1.39 ± 0.91 at baseline to 1.0 ± 0.78 at 6 months (P = 0.003), the percentage of patients with uncontrolled asthma from 41.4% to 17.2% (P = 0.006), and the percentage of patients with asthma attacks in the 6 months before and after treatment from 35.4% to 17.2% (P = 0.015). The score of the mAQLQ increased from 5.12 ± 1.38 to 5.63 ± 1.17 (P = 0.009). There were also significant improvements in symptoms of gastroesophageal reflux and rhinitis, bronchial reversibility, and exhaled nitric oxide values (all P < 0.05). No significant changes were observed in drug therapy for asthma or their comorbidities nor in the patients’ weight.ConclusionsAsthma control (both actual and future risk), quality of life, and lung function improved after starting continuous positive airway pressure in asthmatics with moderate to severe obstructive sleep apnea syndrome.

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Sleep-disordered breathing children

Huang

Zou

Mai

et al. 2016

HNO

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Long-Term Continuous Positive Airway Pressure Therapy Normalizes High Exhaled Nitric Oxide Levels in Obstructive Sleep Apnea

Cited by 36 publications

References 29 publications

Overnight Changes in Lung Function of Obese Patients with Obstructive Sleep Apnoea

Overnight Changes in Lung Function of Obese Patients with Obstructive Sleep Apnoea

Asthma outcomes improve with continuous positive airway pressure for obstructive sleep apnea

Sleep-disordered breathing children

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