Vincent Mysliwiec1, Jessica Gill2, Panagiotis Matsangas3, Tristin Baxter4, Taura Barr5, Bernard J Roth6. 1. Medical Specialties Clinic, 121st General Hospital, Unit #15281, APO AP, 96205-5281, Seoul, Korea. 2. National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA. 3. Department of Operations Research, Naval Postgraduate School, 1411 Cunningham Road, Monterey, CA, 93943, USA. 4. Department of Pulmonary, Critical Care, Sleep Medicine, Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Tacoma, WA, 98431, USA. 5. West Virginia University, 1 Medical Center Drive, Morgantown, WV, 26506, USA. 6. Department of Pulmonary, Critical Care, Sleep Medicine, Madigan Army Medical Center, 9040A Fitzsimmons Avenue, Tacoma, WA, 98431, USA. bernard.j.roth.civ@mail.mil.
Abstract
BACKGROUND: Positive airway pressure (PAP) reverses obstructive sleep apnea (OSA)-related hypoxia and restores slow wave sleep (SWS). Insulin-like growth factor 1 (IGF-1) is a neuropeptide that facilitates the repair of neurons from hypoxia and improves sleep regulation. IGF-1 concentrations are lower in OSA, and likely increase following PAP treatment; however, this relationship has not yet been determined in a younger cohort of OSA patients. METHODS: This was a prospective, observational pilot study of 58 young men, who were diagnosed with OSA and provided PAP as an intervention. Adherence to PAP treatment over 3 months was objectively measured, as well as changes in the apnea-hypopnea index (AHI). Serum concentrations of IGF-1and C-reactive protein (CRP) were measured and correlated with PAP adherence. RESULTS: IGF-1 concentrations at baseline were similar between PAP adherent 55.5 ± 34.4 ng/ml and PAP nonadherent participants 61.2 ± 27.1 ng/ml (p = 0.4), with the overall mean IGF-1 concentration of 59.0 ± 29.9 ng/ml. At follow-up, adherent participants had concentrations of IGF-1 that were significantly higher 128 ± 59.5 ng/ml compared to nonadherent participants 86.0 ± 47.4 ng/ml (p < 0.01). Increases in IGF-1 concentrations were significantly associated with reductions in AHI (Spearman's rho = -0.409, p = 0.015). Conversely, CRP concentrations did not differ between baseline and follow-up measurements in either group. CONCLUSIONS: Adherence to PAP treatment leads to significant increases in IGF-1 concentrations in young men with OSA. While an objective measure of adherence exists, PAP usage does not allow for measure of sleep improvement. IGF-1 may serve as a potential biomarker for the efficacy of PAP therapy on improved sleep.
BACKGROUND: Positive airway pressure (PAP) reverses obstructive sleep apnea (OSA)-related hypoxia and restores slow wave sleep (SWS). Insulin-like growth factor 1 (IGF-1) is a neuropeptide that facilitates the repair of neurons from hypoxia and improves sleep regulation. IGF-1 concentrations are lower in OSA, and likely increase following PAP treatment; however, this relationship has not yet been determined in a younger cohort of OSA patients. METHODS: This was a prospective, observational pilot study of 58 young men, who were diagnosed with OSA and provided PAP as an intervention. Adherence to PAP treatment over 3 months was objectively measured, as well as changes in the apnea-hypopnea index (AHI). Serum concentrations of IGF-1and C-reactive protein (CRP) were measured and correlated with PAP adherence. RESULTS:IGF-1 concentrations at baseline were similar between PAP adherent 55.5 ± 34.4 ng/ml and PAP nonadherent participants 61.2 ± 27.1 ng/ml (p = 0.4), with the overall mean IGF-1 concentration of 59.0 ± 29.9 ng/ml. At follow-up, adherent participants had concentrations of IGF-1 that were significantly higher 128 ± 59.5 ng/ml compared to nonadherent participants 86.0 ± 47.4 ng/ml (p < 0.01). Increases in IGF-1 concentrations were significantly associated with reductions in AHI (Spearman's rho = -0.409, p = 0.015). Conversely, CRP concentrations did not differ between baseline and follow-up measurements in either group. CONCLUSIONS: Adherence to PAP treatment leads to significant increases in IGF-1 concentrations in young men with OSA. While an objective measure of adherence exists, PAP usage does not allow for measure of sleep improvement. IGF-1 may serve as a potential biomarker for the efficacy of PAP therapy on improved sleep.
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