Modelling obstructive sleep apnea susceptibility using non-invasive inflammatory biomarkers

Abstract

Background: Obstructive sleep apnea (OSA) is considered systemic inflammatory disease but airway and systemic inflammatory markers roles in OSA prediction are not widely used in sleep clinics. Aims: To study some simple inflammatory markers in the serum or exhaled breath that may predict OSA diagnosis or severity. Methods: The study included 60 participants, 43 OSAS and 17 healthy control. Cases were recruited from Respiratory Sleep Disorders Clinic full night PSG was done, the next morning, fractional exhaled nitric oxide (FENO) was measured, blood sample were collected for measuring Erythrocyte sedimentation rate (ESR) and high sensitivity C- reactive protein (HS-CRP). Results: Statistically Significant increase in Basal and minimal oxygen saturation, arousal index, FENO, ESR (1st, 2nd hour), HS-CRP with in OSA patients versus controls. While significant increase of HS-CRP, basal, minimal oxygen saturation and arousal index were found in severe OSA no significant differences were founded in (FENO, or ESR (1st, 2nd hour)).The predicted cut off point of FENO, HS-CRP, ESR(1st, 2ndhrs) that can be used in OSA diagnosis were (8,5.5,6.5,13.5) with sensitivity (0.88,0.95,0.83,0.93) and specificity (0.77,0.88,0.63,0.63). While in severe OSA were (24.5, 19.4, 9, 18.5) with sensitivity (0.82, 0.91, 0.82, 0.82) and specificity (0.72, 0.72, 0.72, 0.68) respectively. Conclusion: OSA patients have increased level of HS-CRP, ESR, and Exhaled FENO which confirm association of inflammation in OSA. These simple inflammatory markers may be used also as simple non invasive predictors to diagnose OSA. Moreover, the HS-CRP may be used as a useful parameter to predict OSA severity.

Keywords

• OSA
• FENO
• Exhaled NO
• Inflammatory markers