0680 The Effect of Continuous Positive Airway Pressure on the Levels of the Proinflammatory Markers in Patients with Obstructive Sleep Apnea

Introduction

Obstructive sleep apnea (OSA) develops systemic inflammation, with increased levels of mediators. In general, significant elevations in serum levels of C-reactive proteins (CRP), and interleukin 6 (IL-6) are seen in patients with OSA. The literature is inconsistent regarding the effect of Continuous Positive Airway Pressure (CPAP) on the level of CRP and IL-6. The aim of this study is to evaluate the effect of CPAP on the levels of IL-6 and CRP in patients with OSA.

Methods

All patients newly diagnosed with moderate-severe OSA at the King Abdulaziz university sleep center were targeted. Patients with conditions that may affect the levels of inflammatory markers were excluded. All included patients had their fasting blood taken post the initial diagnostic polysomnography for pro-inflammatory markers. Patients were then classified into two groups. The first group included those that accepted treatment with CPAP (CPAPG). The second group included patients with OSA but refused treatment (No-CPAPG). Each group had been followed for one month, and then another blood samples were drawn for the levels of the pro-inflammatory biomarkers.

Results

Twenty patients in each group were recruited. At baseline IL-6 was significantly higher in the No-CPAPG compared to CPAPG (median 6.7 pg/ml [interquartile range 1.6-7.6] vs. 1.6 pg/ml [1.3-1.9], respectively; p = 0.006) despite similar OSA severity. At 1-month follow-up, IL-6 remained significantly higher in the No-CPAPG; p = 0.003 and there was no effect of CPAP on IL-6 in the CPAPG. There was no significant difference in CRP level at baseline or at 1-month follow-up among the two groups. However, there was neither an effect of time (F (1, 38) = 0.08, p = 0.78), nor an interaction effect between CPAP and time (F(1, 38) = 0.006, p = 0.94) on IL-6 level. Similarly, there was neither an effect of time (F(1, 38) = 1.68, p = 0.20), nor an interaction effect between CPAP and time (F(1, 38) = 0.17, p = 0.68) on CRP level.

Conclusion

IL-6 and CRP levels did not change significantly with CPAP over a one month period in OSA patients.

Support

By the DSR, KAU, Jeddah, KSA. No: KEP-2-140-39