Journal Article

Effect of continuous positive airway pressure on inflammatory, antioxidant, and depression biomarkers in women with obstructive sleep apnea: a randomized controlled trial

Asensio-Cruz, Maria Isabel, Cordero-Guevara, Jose, Somoza-Gonzalez, Maria, Caballero-Rodriguez, Julian, Garcia-Sanchez, Maria Isabel, Sanchez-Lopez, Veronica, Arellano-Orden, Elena, Jurado-Gamez, Bernabe, Troncoso, Maria F, Navarro-Esteva, Javier, Martin-Romero, Mercedes, Sanchez-Armengol, Angeles, Sacristan-Bou, Lirios, Campos-Rodriguez, Francisco, Carmona-Bernal, Carmen, Martinez-Garcia, Miguel Angel, Masa, Juan F, Gonzalez-Martinez, Monica, Alonso-Alvarez, Maria L, Reyes-Nuñez, Nuria, Sedano, Andrea Crespo, Abad-Fernandez, Araceli, Encabo-Motiño, Ana

2019

Overview

The effect of continuous positive airway pressure (CPAP) on mediators of cardiovascular disease and depression in women with obstructive sleep apnea (OSA) is unknown. We aimed to assess the effect of CPAP therapy on a variety of biomarkers of inflammation, antioxidant activity, and depression in women with OSA. We conducted a multicenter, randomized controlled trial in 247 women diagnosed with moderate-to-severe OSA (apnea-hypopnea index [AHI] ≥ 15). Women were randomized to CPAP (n = 120) or conservative treatment (n = 127) for 12 weeks. Changes in tumor necrosis factor α (TNFα), interleukin 6 (IL-6), C-reactive protein (CRP), intercellular adhesion molecule 1 (ICAM-1), catalase (CAT), superoxide dismutase (SOD), and brain-derived neurotrophic factor (BDNF) were assessed. Additional analyses were conducted in subgroups of clinical interest. Women had a median (25th-75th percentiles) age of 58 (51-65) years, body mass index 33.5 (29.0-38.3) kg/m2, and AHI 33.3 (22.8-49.3). No differences were found between groups in the baseline levels of the biomarkers. After 12 weeks of follow-up, there were no changes between groups in any of the biomarkers assessed. These results did not change when the analyses were restricted to sleepy women or to those with severe OSA. In women with CPAP use at least 5 hours per night, only TNFα levels decreased compared to the control group (-0.29 ± 1.1 vs -0.06 ± 0.53, intergroup difference -0.23 [95% CI = -0.03 to -0.50]; p = 0.043). Twelve weeks of CPAP therapy does not improve biomarkers of inflammation, antioxidant activity, or depression compared to conservative treatment in women with moderate-to-severe OSA. NCT02047071.

• Publisher: Oxford University Press
• Subject: Aged / Analysis / Antioxidants / Antioxidants - metabolism / Biological markers / Biomarkers / Biomarkers - blood / C-reactive protein / Cardiovascular diseases / Clinical trials / Continuous positive airway pressure / Continuous Positive Airway Pressure - methods / Continuous Positive Airway Pressure - trends / Depression - blood / Depression - diagnosis / Depression - therapy / Female / Follow-Up Studies / Humans / Inflammation Mediators - blood / Interleukins / Mental depression / Middle Aged / Oxidative stress / Psychological aspects / Sleep apnea / Sleep apnea syndromes / Sleep Apnea, Obstructive - blood / Sleep Apnea, Obstructive - diagnosis / Sleep Apnea, Obstructive - physiopathology / Sleep Apnea, Obstructive - therapy / Superoxide / Treatment Outcome / Tumor necrosis factor