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Short-term CPAP or moderate aerobic exercise do not improve oxidative stress and inflammatory biomarkers in obstructive sleep apnea
Previous studies have shown that the levels of oxidative stress, inflammatory and cell-free DNA (cfDNA) markers are increased in individuals suffering from obstructive sleep apnea (OSA). The effects of medium to long-term CPAP therapy and physical activity in decreasing these levels have been somewhat explored, unlike short-term interventions.
Evaluate oxidative stress marker, pro-inflammatory cytokines, anti-inflammatory cytokines, and cfDNA levels before and after 8-week CPAP treatment or moderate-intensity aerobic training in moderate to severe OSA.
Thirty-nine patients diagnosed with OSA were randomly divided into CPAP (n=18) – with and without humidifier – and exercise (n=21) groups. They were all submitted to the Epworth Sleepiness Scale and the Pittsburgh questionnaire. Blood samples were taken for the quantification of lipid oxidation (TBARS), protein oxidation (AOPP) and antioxidant (SOD) biomarkers, as well as pro-inflammatory (TNF-α, IL-1β, IL-6, IL-8, IL-17A) anti-inflammatory cytokines (IL-4, IL-10) and cfDNA, before and after 8 weeks of either CPAP therapy or moderate-intensity aerobic exercise. Comparisons between averages were made with the Student’s t test for dependent samples when the Shapiro test indicated parametric and, if not, the Wilcoxon test. A 95% confidence interval and a significance level of 5% were considered.
After 8 weeks of either CPAP therapy or exercise no significant differences were observed in the levels of cfDNA, oxidative stress and inflammation markers, except for an increase in AOPP (6.6±3.9 / 10.5±6.8, p=0.02) and IL-17A (21(8.4) / 29(6.7), p<0.001) levels in individuals who went through CPAP, which were higher when the CPAP device was used without the humidifier (AOPP: 6,13±2,74 / 10,67±7,06, p<0.05 and IL-17A: 21,4±7,42 / 33,7±14,82, p<0.05). The 8-week CPAP therapy promoted a significant decrease in the Pittsburgh scores, while ESS scores remained unaffected. No significant changes were observed in these parameters after the exercise treatment.
Short-term treatment for OSA, be it CPAP therapy or moderate-intensity aerobic exercise, was not sufficient to alter either the oxidative stress and inflammatory profiles or the cell-free DNA levels of moderate to severe OSA patients. However, short-term CPAP did improve self-reported sleep quality.
OSA; CPAP; Aerobic exercise; Oxidative stress; Inflammation.
MARIA TERESA MARTINS ARAÚJO, YTALO GONÇALVES BORGES, LUIS HENRIQUE CEIA CIPRIANO, RAFAELA AIRES, PAULO VINICIOS CAMUZI ZOVICO, FABIANA VASCONCELOS CAMPOS, SONIA ALVES GOUVEA