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Inflammatory proteins in patients with obstructive sleep apnea with and without daytime sleepiness

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Abstract

Excessive daytime sleepiness (EDS) is one of the most frequent symptoms in patients with obstructive sleep apnea syndrome (OSAS). However, not all patients with OSAS manifest EDS. The aim of this study was to assess whether differential circulatory levels of inflammatory mediators would account for differences in somnolence among patients with OSAS. Patients were prospectively recruited from referral patient cohort to the university hospital sleep center. A total of 50 consecutive patients with OSAS undergoing overnight polysomnography with or without EDS and 20 controls were evaluated. EDS was assessed using the Epworth sleepiness scale (ESS) and the multiple sleep latency test after overnight polysomnography. EDS was defined when the ESS was >10 and the mean sleep latency <10 min. Fasting blood was drawn in the morning after polysomnography. Circulating levels of tumor necrosis factor alpha (TNFα), interleukin-6 (IL-6), intercellular adhesion molecule 1 (ICAM-1), 8-isoprostaglandin F2α (8-iso-PGF2α), and P-selectin were measured with commercially available high sensitivity kits. Although patients with OSAS have elevated levels of ICAM-1, IL-6, and TNFα, there were no statistically significant differences in any of the inflammatory mediators between patients with EDS and without EDS. Emergence of EDS in the context of OSA does not appear to result from the selective increase of any particular somnogenic substance, i.e., TNFα, IL-6, ICAM-1, 8-iso-PGF2α, and P-selectin in the context of sleep-disordered breathing.

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Acknowledgment

This study was supported by grants from the National Institutes of Health HL65270, The Children’s Foundation Endowment for Sleep Research, the Commonwealth of Kentucky Challenge for Excellence Trust Fund to DG, the Fondo de Investigaciones Sanitarias from Spain (02/0334, 04/1593 and CM-0300049), and by Red Respira (RTIC 03/11) to FB.

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Authors and Affiliations

  1. Hospital Universitario Son Dureta, Servicio de Neumología, Palma de Mallorca, Baleares, 07014, Spain

    Mónica de la Peña Bravo & Alvar Agustí

  2. Department of Pediatrics, Division of Pediatric Sleep Medicine, Kosair Children’s Hospital Research Institute, University of Louisville, Louisville, KY, 40202, USA

    Laura D. Serpero & David Gozal

  3. Hospital Universitario Son Dureta, Servicio de Análisis Clínicos, Palma de Mallorca, Baleares, 07014, Spain

    Antonia Barceló

  4. Servei de Pneumología, Hospital Univ Arnau de Vilanova, C/ Rovira Roure 80, Lleida, Catalonia, 25198, Spain

    Ferran Barbé

  5. KCHRI, 570 S. Preston Street, Suite 204, Louisville, KY, 40202, USA

    David Gozal

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  1. Mónica de la Peña Bravo
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  2. Laura D. Serpero
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  3. Antonia Barceló
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Correspondence to David Gozal.

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The work was performed in Hospital Universitario Son Dureta and Kosair Children’s Hospital Research Institute.

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Bravo, M., Serpero, L.D., Barceló, A. et al. Inflammatory proteins in patients with obstructive sleep apnea with and without daytime sleepiness. Sleep Breath 11, 177–185 (2007). https://doi.org/10.1007/s11325-007-0100-7

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