Document Detail

Effects of nasal continuous positive airway pressure and oxygen supplementation on norepinephrine kinetics and cardiovascular responses in obstructive sleep apnea.
MedLine Citation:
PMID:  16357087     Owner:  NLM     Status:  MEDLINE    
Obstructive sleep apnea (OSA) is characterized by noradrenergic activation. Nasal continuous positive airway pressure (CPAP) is the treatment of choice and has been shown to effectively reduce elevated norepinephrine (NE) levels. This study examined whether the reduction in NE after CPAP is due to an increase in NE clearance and/or a decrease of NE release rate. Fifty CPAP-naive OSA patients with an apnea-hypopnea index >15 were studied. NE clearance and release rates, circulating NE levels, urinary NE excretion, and blood pressure and heart rate were determined before and after 14 days of CPAP, placebo CPAP (CPAP administered at ineffective pressure), or oxygen supplementation. CPAP led to a significant increase in NE clearance (P < or = 0.01), as well as decreases in plasma NE levels (P < or = 0.018) and daytime (P < 0.001) and nighttime (P < 0.05) NE excretion. NE release rate was unchanged with treatment. Systolic (P < or = 0.013) and diastolic (P < or = 0.026) blood pressure and heart rate (P < or = 0.014) were decreased in response to CPAP but not in response to oxygen or placebo CPAP treatment. Posttreatment systolic blood pressure was best predicted by pretreatment systolic blood pressure and posttreatment NE clearance and release rate (P < 0.01). The findings indicate that one of the mechanisms through which CPAP reduces NE levels is through an increase in the clearance of NE from the circulation.
Paul J Mills; Brian P Kennedy; Jose S Loredo; Joel E Dimsdale; Michael G Ziegler
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  100     ISSN:  8750-7587     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-16     Completed Date:  2006-02-01     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  343-8     Citation Subset:  IM    
Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
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MeSH Terms
Blood Pressure*
Continuous Positive Airway Pressure / methods*
Energy Metabolism
Heart Rate*
Metabolic Clearance Rate
Middle Aged
Norepinephrine / blood,  metabolism*,  urine
Oxygen / administration & dosage*
Single-Blind Method
Sleep Apnea, Obstructive / blood,  physiopathology*,  therapy*
Grant Support
Reg. No./Substance:
51-41-2/Norepinephrine; 7782-44-7/Oxygen
Comment In:
J Appl Physiol (1985). 2006 Jan;100(1):11-2   [PMID:  16357080 ]

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