SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science I. Sleep Disorders – Breathing
and sleep disorders rather than BMI in OSAS patients, suggesting that
plasma vaspin level is a potential biomarker of the pathophysiology associated
with OSAS.
0452
EFFECTS OF OBSTRUCTIVE SLEEP APNEA ON
LEUKOCYTES PROFILE: A POPULATION-BASED SURVEY
Ruiz FS 1 , Andersen ML 1 , Araujo P 1 , Hachul H 1,2 , Santos-Silva R 1 ,
Bittencourt LA 1 , Tufik S 1
1
Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil,
2
Ginecologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
Introduction: Accumulating evidence suggests that sleep loss can impact
the immune profile in experimental conditions. However, investigations
focusing whether sleep disorders are associated with host defense
alterations in epidemiological studies are still limited. Aim: This study
was undertaken to evaluate whether obstructive sleep apnea syndrome
(OSAS), one of the most prevalent sleep disorder, was associated with
hematologic changes in a sample representative of the population of Sao
Paulo, Brazil.
Methods: A sample of 1042 subjects was used to represent the population
of Sao Paulo city according to gender, age (20-80 years), and socioeconomic
status. Hematological analysis of venous blood and a full
polysomnography were carried out.
Results: It was found significant increased leukocytes number in OSAS
subjects. Further analysis considering sex-differences demonstrated that
the leukocytes number was increased only in premenopausal women.
Linear regression analysis using backward method showed the following
factors that independently predicted the leukocytes alterations:
neutrophils, TNF-α, estradiol, age, current smoker, cortisol, body mass
index and oxyhemoglobin saturation.
Conclusion: The results showed that sleep apnea was associated with an
exclusive increase of leukocytes in women during the young ages. The
data highlighted that several outcomes induced by OSAS were determinants
in the altered immune profile, indicating the influence of sleep
disruption on immunity. Finally, sleep fragmentation induced by OSAS
seems to be involved in the bidirectional relationship between sleep
quality and immune response.
Support (If Any): FAPESP (#07/55445-6 to FSR and CEPID
#98/14303-3 to ST), Associação Fundo de Incentivo à Psicofarmacologia
(AFIP) and CNPq
0453
ASSOCIATION BETWEEN URIC ACID LEVELS, HYPOXIA
AND SLEEP APNEA: A POPULATION-BASED SURVEY
Hirotsu C, Tufik S, Bittencourt LA, Santos-Silva R, Andersen ML
Departamento de Psicobiologia, Universidade Federal de Sao Paulo,
Sao Paulo, Brazil
Introduction: Recurrent hypoxia associated with obstructive sleep
apnea syndrome leads to an increase in the degradation of adenosine
triphosphatase into xanthine, which in turn increases uric acid concentrations.
The current study aimed to determine whether a correlation
exists between uric acid levels in the peripheral blood and the arterial
oxyhemoglobin saturation (SpO2) from a representative population of
Sao Paulo.
Methods: A population-based survey adopting a probabilistic threestage
cluster sample of Sao Paulo was used to represent the population
according to gender, age and socioeconomic class. A total of 1,021 volunteers
underwent polysomnography recordings, blood pressure assessment
and biochemical blood analysis.
Results: The results indicated that 30.3% of women and 48.3% of
men with an apnea-hypopnea index (AHI)>5 had higher uric acid levels
compared with normal gender-matched individuals. Men presented
higher levels of uric acid than women, independent of AHI. Uric acid
levels were significantly correlated with AHI, systolic blood pressure,
SpO2, arousal index, percentage of slow-wave sleep, creatinine, sodium,
cholesterol, triglycerides and glucose levels. A linear regression model
revealed that the predictors for uric acid concentration were gender, creatinine,
triglycerides, systolic blood pressure, SpO2 and HDL. However,
when the model was controlled for body mass index, the influence of
SpO2 decreased in the model.
Conclusion: Uric acid levels were positively correlated with the number
of obstructive respiratory episodes during sleep and present a possible
marker for sleep apnea. Nevertheless, this association seems to be influenced
by a confounding factor: obesity.
Support (If Any): This work was supported by grants from AFIP,
FAPESP and CNPq.
0454
QUALITY OF LIFE, DEPRESSION AND ANXIETY SCORES IN
SLEEPY AND NON-SLEEPY OSA SUBJECTS
Skomro R, Reid JK, Gjevre J, Fenton M, Stiles M, Cotton D
Medicine, University of Saskatchewan, Saskatoon, SK, Canada
Introduction: Excessive daytime sleepiness, a common symptom of
OSA, negatively impacts QoL in these patients. It is not clear however
whether non-sleepy OSA patients have similar impairments in QoL, and
if mood or anxiety scores are affected independently of daytime sleepiness.
The objective of this study was to compare the Quality of Life,
depression and anxiety scores in sleepy and non-sleepy OSA subjects.
Methods: One hundred and two consecutive patients referred to a tertiary
sleep disorders clinic for evaluation of OSA completed SF-36, CES
Depression Scale, State-Trait Anxiety Inventory (STAI), ESS, and underwent
an in-lab PSG. Patients diagnosed with OSA (AHI > 5) were
classified based on subjective sleepiness scores as sleepy (ESS ≥ 10)and
non-sleepy (ESS < 10). Groups were matched for age, sex and BMI. We
compared SF-36, PSQI, STAY-1 and STAY - 2 as well as CES depression
scores between sleepy and non-sleepy patients prior to initiating
CPAP therapy.
Results: The sleepy OSA group had significantly worse depression
(17.44 ± 10.16 vs. 10.86 ± 7.30, p = 0.02) and STAI anxiety scores
(35.92 ± 9.95 vs 30.26 ± 6.87, p = 0.04) than the non-sleepy OSA patients.
Non-sleepy and sleepy OSA patients had similar impairments in
SF-36 Vitality and MCS scores. There was no significant correlation
between ESS and SF-36 Vitality scores. There was a weak correlation
between ESS and depression and anxiety scores.
Conclusion: Sleepy OSA patients demonstrate worse depression and
anxiety scores than non-sleepy subjects. Non-sleepy and sleepy OSA
patients have similar decrements in general health QoL scores as measured
by SF-36. Furthermore ESS scores do not correlate with SF-36
QoL scores in OSA subjects.
Support (If Any): The study was supported by Lung Association of
Saskatchewan, Kelsey Trail Health Region and Saskatoon Health Region.
0455
EFFECTS OF TRAZODONE ON THE RESPIRATORY
AROUSAL THRESHOLD AND UPPER AIRWAY DILATOR
MUSCLE RESPONSIVENESS DURING SLEEP IN
OBSTRUCTIVE SLEEP APNEA
Eckert DJ, Kehlmann G, Wellman A, White D, Malhotra A
Division of Sleep Medicine, Sleep Disorders Program, Brigham and
Women’s Hospital and Harvard Medical School, Boston, MA, USA
Introduction: Cessation of respiratory events occurs via 1) arousal from
sleep or 2) sufficient recruitment of upper airway (UA) dilator muscles
to restore airflow without arousal. Thus, a low respiratory arousal threshold
(awaken easily to respiratory stimuli) is likely to be important in the
pathogenesis of OSA for some patients. Increasing the arousal threshold
with a hypnotic to enable UA muscle recruitment and restore airflow
without arousal may be a therapeutic option in appropriately selected pa-
SLEEP, Volume 34, Abstract Supplement, 2011
A156