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1519761 
Journal Article 
Effects of CPAP on nitrate and norepinephrine levels in severe and mild-moderate sleep apnea 
Pinto, P; Bárbara, C; Montserrat, JM; Patarrão, RS; Guarino, MP; Carmo, MM; Macedo, MP; Martinho, C; Dias, R; Gomes, MJ 
2013 
Yes 
BMC Pulmonary Medicine
ISSN: 1471-2466 
13 
13 
English 
BACKGROUND: Reduced plasma nitrate (NOx) levels and increased urinary norepinephrine (U-NE) levels have been described in severe obstructive sleep apnea (OSA), and are reverted by continuous positive airway pressure (CPAP). The effect of CPAP on these biomarkers in mild-moderate OSA is not well understood.The aim of this study was to compare NOx and U-NE levels and blood pressure (BP) between male patients with mild-moderate and severe OSA and determine the impact of 1 month of CPAP therapy on these parameters.

METHODS: We undertook a prospective study of 67 consecutive OSA patients (36 mild-moderate, 31 severe). Measurements of plasma NOx at 11 pm, 4 am and 7 am, 24-h U-NE and ambulatory BP were obtained at baseline and after 1 month of CPAP.

RESULTS: At baseline, NOx levels showed a significant decrease during the night in both groups (p < 0.001). U-NE level and BP were significantly higher in the severe OSA group. After 1 month of CPAP, there was a significant increase in NOx levels and a reduction in U-NE level and BP only in patients with severe OSA.

CONCLUSIONS: One month of CPAP results in significant improvements in NOx levels, 24-h U-NE level and BP in patients with severe OSA, but not in patients with mild-moderate OSA.

TRIAL REGISTRATION: ClinicalTrials.gov: http://NCT01769807. 
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