Fractional Exhaled Nitric Oxide and CRP Levels in Egyptian Patients With Obstructive Sleep Apnea Syndrome

This study is a prospective 3 months follow up study including only (27) participants as a convenient sample for the cost limitations newly diagnosed as OSA and (10) healthy control.

inclusion characters All participants enrolled in this study

1. were ≥ 18 years old,
2. non-smokers and
3. excluded from any inflammatory disorders (allergy, bronchial asthma, gastro-esophageal reflux disease, cardiovascular diseases, and cerebrovascular diseases) or use of any regular medication including (nasal/inhaled/oral corticosteroids, antihistaminic, cysteinyl leukotriene receptor inhibitors), or
4. had an upper or lower respiratory tract infection 2 weeks prior to sampling. Control healthy subjects were also free from any sleep disorders symptoms. Cases were recruited from Sleep-disordered breathing unit out Patient Clinic in pulmonary medicine department - Mansoura University - Egypt. All participants in this study were evaluated by history taking with stress on OSAS questionnaires, anthropometric parameters measurement and spirometric pulmonary function (FEV1, FVC and FEV1/FVC ) all patients were subjected to laboratory, attended, full-night polysomnography using (SONMOscreenTMplus, SOMNOmedics, (Germany) with AASM standard montage, This included a standardized montage: two-channel electroencephalograms (EEG; C4/A1, C3/A2), bilateral electrooculogram (EOG), submental electromyogram (EMG), bilateral leg EMGs, and electrocardiography (ECG). Airflow was measured using a thermistor (Healthdyne Technologies), the respiratory effort was assessed by inductance plethysmography and oxygen saturation was recorded using a finger probe. The oxygen saturation signal was digitally sampled at 1 Hz and stored both on the PSG record and in a separate monitor for offline analysis.

studies were interpreted according to the last manual scoring criteria. The cases were diagnosed as severe OSA according to the third international classification of sleep disorders. Then they were classified according to apnea-hypopnea index (AHI) into two main groups: cases (AHI ≥5) (n=) and control (AHI˂5) (n=10). Cases were classified into two subgroups into severe OSA (AHI ≥ 30) (n=34) and moderate OSA (AHI (15-30) mild (n=10).

On the next morning of the study 30 min after PSG, the blood sample was collected for measuring of high sensitivity C- reactive protein (HS-CRP) by (The Immunospec Hs-CRP) ELISA, based on the principle of a solid phase enzyme-linked immunosorbent assay [15]. The assay system utilizes a unique monoclonal antibody directed against a distinct antigenic determinant on the CRP molecule.