Satoshi Hamada1,2, Shuji Tatsumi3, Yoshiki Kobayashi4, Hirotaka Yasuba3. 1. Department of Respiratory Medicine, Hikone Municipal Hospital, 1882 Hassakacho, Hikone, 522-8539, Japan. sh1124@kuhp.kyoto-u.ac.jp. 2. Department of Airway Medicine, Mitsubishi Kyoto Hospital, 1 Katsuragoshocho, Nishikyo-ku, Kyoto, 615-8087, Japan. sh1124@kuhp.kyoto-u.ac.jp. 3. Department of Airway Medicine, Mitsubishi Kyoto Hospital, 1 Katsuragoshocho, Nishikyo-ku, Kyoto, 615-8087, Japan. 4. Department of Otolaryngology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan.
Abstract
PURPOSE: In this report, we examined the association between obstructive sleep apnea (OSA) and upper and lower airway inflammation based on nitric oxide (NO) measurements. METHODS: Study subjects included 51 consecutive participants. Sleep-disordered breathing was evaluated by a type 3 portable monitor and quantified by respiratory disturbance index (RDI). Airway inflammation was noninvasively analyzed by the measurement of nasally and orally exhaled NO; nasal value was presented as nasally exhaled NO minus orally exhaled NO. In 15 patients prescribed nasal continuous positive airway pressure (nCPAP) therapy, exhaled NO was re-evaluated in 10.7 ± 6.3 months after nCPAP therapy. RESULTS: Nasal NO was significantly higher in patients with severe OSA (RDI ≥ 30/h) than those with non-OSA (RDI < 10/h) (76.9 ± 26.0 ppb vs. 47.9 ± 22.0 ppb, respectively, p = 0.016) and correlated with RDI (rho = 0.36, p = 0.0099), whereas orally exhaled NO did not differ between non-OSA and OSA patients and was not correlated with RDI. In 15 patients, nasal NO after nCPAP therapy was significantly decreased than that before nCPAP therapy (81.9 ± 31.2 ppb vs. 53.7 ± 27.2 ppb, respectively, p = 0.0046); in 11 patients having good compliance to nCPAP therapy (nCPAP use >4 h per night on more than 70% of nights), this association was more remarkable. CONCLUSIONS: In OSA, upper but not lower airway inflammation can be increased by repetitive collapse of the upper airway. Future studies are required to determine the role of nasal NO in OSA.
PURPOSE: In this report, we examined the association between obstructive sleep apnea (OSA) and upper and lower airway inflammation based on nitric oxide (NO) measurements. METHODS: Study subjects included 51 consecutive participants. Sleep-disordered breathing was evaluated by a type 3 portable monitor and quantified by respiratory disturbance index (RDI). Airway inflammation was noninvasively analyzed by the measurement of nasally and orally exhaled NO; nasal value was presented as nasally exhaled NO minus orally exhaled NO. In 15 patients prescribed nasal continuous positive airway pressure (nCPAP) therapy, exhaled NO was re-evaluated in 10.7 ± 6.3 months after nCPAP therapy. RESULTS: Nasal NO was significantly higher in patients with severe OSA (RDI ≥ 30/h) than those with non-OSA (RDI < 10/h) (76.9 ± 26.0 ppb vs. 47.9 ± 22.0 ppb, respectively, p = 0.016) and correlated with RDI (rho = 0.36, p = 0.0099), whereas orally exhaled NO did not differ between non-OSA and OSA patients and was not correlated with RDI. In 15 patients, nasal NO after nCPAP therapy was significantly decreased than that before nCPAP therapy (81.9 ± 31.2 ppb vs. 53.7 ± 27.2 ppb, respectively, p = 0.0046); in 11 patients having good compliance to nCPAP therapy (nCPAP use >4 h per night on more than 70% of nights), this association was more remarkable. CONCLUSIONS: In OSA, upper but not lower airway inflammation can be increased by repetitive collapse of the upper airway. Future studies are required to determine the role of nasal NO in OSA.
Authors: Amir Qaseem; Paul Dallas; Douglas K Owens; Melissa Starkey; Jon-Erik C Holty; Paul Shekelle Journal: Ann Intern Med Date: 2014-08-05 Impact factor: 25.391
Authors: Benjamin G Wu; Imran Sulaiman; Jing Wang; Nan Shen; Jose C Clemente; Yonghua Li; Robert J Laumbach; Shou-En Lu; Iris Udasin; Oanh Le-Hoang; Alan Perez; Shahnaz Alimokhtari; Kathleen Black; Michael Plietz; Akosua Twumasi; Haley Sanders; Patrick Malecha; Bianca Kapoor; Benjamin D Scaglione; Anbang Wang; Cameron Blazoski; Michael D Weiden; David M Rapoport; Denise Harrison; Nishay Chitkara; Eugenio Vicente; José M Marin; Jag Sunderram; Indu Ayappa; Leopoldo N Segal Journal: Am J Respir Crit Care Med Date: 2019-01-01 Impact factor: 21.405