Sleep Breath 2003; 07(3): 105-110
DOI: 10.1055/s-2003-43071
ORIGINAL ARTICLE

Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Reactive Oxygen Metabolites (ROMs) as an Index of Oxidative Stress in Obstructive Sleep Apnea Patients

Kostas Christou, Nikolaos Markoulis, Anargyros N. Moulas, Chaido Pastaka, Kostantinos I. Gourgoulianis
  • Pulmonary Department, Medical School, University of Thessaly, Larissa, Greece
Further Information

Publication History

Publication Date:
21 October 2003 (online)

ABSTRACT

Study Objectives: Obstructive sleep apnea syndrome (OSA) is accompanied by oxygen desaturation and arousal from sleep. Free oxygen radicals are highly reactive molecules which could be produced by the OSA phenomenon of hypoxia/reoxygenation: cyclical alterations of arterial oxygen saturation with oxygen desaturation developing in response to apneas followed by resumption of oxygen saturation during hyperventilation. On the basis of these considerations, it was hypothesized that OSA may be linked to increased oxidative stress. Materials and methods: Twenty-six participants gave an interview during which a physician asked them about their age, smoking habits, and symptoms such as excessive daytime sleepiness and snoring. Physical examination and polysomnography were performed during their hospitalization. Reactive oxygen metabolites (ROMs) were measured in blood samples by the diacron reactive oxygen metabolites (D-ROM) test. Results: Twenty-one out of 26 subjects had an apnea/hypopnea index greater than 5 (OSA group). The measurement of free radicals was high in OSA patients. Furthermore, ROMs values in OSA patients were linearly correlated with the apnea/hypopnea index (R = 0.426; p = 0.042). The predictive value of a positive D-ROM test is 81%. Conclusions: ROMs were elevated in patients with OSA. When OSA was severe, similarly the value of ROMs in blood samples was enhanced, and the probable underlying mechanism for these events is the hypoxia/reoxygenation phenomenon.

REFERENCES

  • 1 American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research.  Sleep . 1999;  22 667-689
  • 2 Pack A I. Obstructive sleep apnea.  Adv Intern Med . 1994;  39 517-567
  • 3 Halliwell B. Free radicals, antioxidants and human disease: curiosity, cause or consequence?.  Lancet . 1994;  344 721-724
  • 4 Halliwell B. The role of oxygen radicals in human disease with particular reference to the vascular system.  Haemostasis . 1993;  23 118-126
  • 5 Mugge A. The role of reactive oxygen species in atherosclerosis.  Z Kardiol . 1998;  87 851-864
  • 6 Shepard J W. Hypertension, cardiac arrhythmia, myocardial infarction and stroke in relation to obstructive sleep apnea.  Clin Chest Med . 1992;  13 437-458
  • 7 Dean R T, Wilcox I. Possible atherogenic effects of hypoxia during obstructive sleep apnea.  Sleep . 1993;  16 S15-S22
  • 8 Rechtschaffen A, Kales A. A Manual of Standardized Terminology: Techniques and Scoring System for Sleep Stages of Human Subjects.  Los Angeles, CA: UCLA Brain Information Service/Brain Research Institute . 1968; 
  • 9 Cesarone M, Belcaro G, Carratelli M. et al . A simple test to monitor oxidative stress.  Int Angiol . 1999;  18 127-130
  • 10 Schulz R, Mahmoudi S, Hattar K. et al . Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea. Impact of continuous positive airway pressure therapy.  Amer J Respir Crit Care Med . 2000;  162(2, pt 1) 566-570
  • 11 Halliwell B. The role of oxygen radicals in human disease with particular reference to the vascular system.  Haemostasis . 1993;  23 118-126
  • 12 Richards D CH, Jessup W, Dean R T. Cell surface proteins may be the primary targets during free radical-mediated cytolysis.  Biochim Biophys Acta . 1988;  946 281-288
  • 13 Vince G S, Dean R T. Is enhanced free radical flux associated with increased intracellular proteolysis?.  FEBS Lett . 1987;  216 253-256
  • 14 Cornelli U, Cornelli M, Terranova R. Free radicals and vascular disease.  Int Union Angiol Bull . 1999;  15 7-10
  • 15 Ray G, Husain S A. Role of lipids, lipoproteins and vitamins in women with breast cancer.  Clin Biochem 2001 Feb;34:71-76.
  • 16 Trotti R, Carratelli M, Barbieri M. Performance and clinical application of a new, fast method for the detection of hydroperoxides in serum.  Panminerva Med . 2002;  44 37-40
  • 17 Iamele L, Fiocchi R, Vernocchi A. Evaluation of an automated spectrophotometric assay for reactive oxygen metabolites in serum.  Clin Chem Lab Med. 2002;  40 673-676
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