Sleep Breath 2003; 07: 053-062 DOI: 10.1055/s-2003-40663
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662
Nitric Oxide (NO) and Obstructive Sleep Apnea (OSA)
James S. J. Haight1, Per Gisle Djupesland2
1Department of Otorhinolaryngology, St. Michael's Hospital, University of Toronto, Toronto, Canada 2OptiNose AS, Løkkaskogen 18c, 0773 Oslo, Norway

ABSTRACT

Nitric oxide (NO) and obstructive sleep apnea are inseparable. Obstructive sleep apnea could be described as the intermittent failure to transport the full complement of nasal NO to the lung with each breath. There NO matches perfusion to ventilation. NO is utilized by the efferent pathways that control the unequal, inspiratory battle between the pharyngeal dilators and the closing negative pressures induced by the thoracic musculature. Recurrent cortical arousals are a major short-term complication, and the return to sleep after each arousal uses NO. The long-term complications, namely hypertension, myocardial infarction, and stroke, might be due to the repeated temporary dearth of NO in the tissues, secondary to a lack of oxygen, one of NO's two essential substrates.

KEYWORDS

Nitric oxide - sleep apnea - sleep-disordered breathing - airway obstruction - hypoxia - arousals