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doi:10.1378/chest.06-2348
(Chest. 2007; 131:1400-1405)
© 2007 American College of Chest Physicians
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Relationship Between Serum Substance P Levels and Daytime Sleepiness in Obstructive Sleep Apnea Syndrome*

Ahmet Ursavas, MD; Mehmet Karadag, MD; Yesim Ozarda Ilcol, MD; Basak Burgazlioglu, MD; Ilker Ercan, PhD and R. Oktay Gozu, MD

* From the Departments of Pulmonary Medicine (Drs. Ursavas, Karadag, Burgazlioglu, and Gozu), Biochemistry (Dr. Ilcol), and Biostatistics (Dr. Ercan), School of Medicine, University Of Uludag, Bursa, Turkey.

Correspondence to: Ahmet Ursavas, MD, Uludag Üniversitesi Tip Fakültesi, Gögüs Hastaliklari ve Tüberküloz AD, 16059 Görükle/Bursa/Turkey; e-mail: ahmetursavas{at}gmail.com

Abstract

Objective: We hypothesized that intermittent hypoxia might influence serum substance P levels, and that this effect might in turn contribute in excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea syndrome (OSAS).

Patients and methods: Fifty-five patients with newly diagnosed OSAS and 15 age-matched nonapneic control subjects were enrolled in this study. Full polysomnography was performed in all patients. Single blood samples were drawn between 8:00 AM and 9:00 AM after the sleep study. Substance P levels were analyzed with a competitive enzyme immunoassay (substance P EIA kit; Cayman Chemical; Ann Arbor, MI).

Results: There were no significant differences in age, gender, body mass index, smoking habit, and snoring between the two groups. Serum substance P levels in the OSAS group were significantly lower than that in the control group (p < 0.0001). Serum substance P levels were positively correlated with rapid eye movement sleep (r = 0.330, p = 0.049) and slow-wave sleep (r = 0.324, p = 0.049) phases. Serum substance P levels were negatively correlated with Epworth sleepiness scale score (r = – 0.253, p = 0.048), number of total apneas during the night (r = – 0.247, p = 0.036), number of respiratory events during the night (r = – 0.266, p = 0.024), apnea-hypopnea index (r = – 0.287, p = 0.015), respiratory arousal index (r = – 0.267, p = 0.026), time spent in apnea and hypopnea (r = – 0.307, p = 0.01), average oxygen desaturation (r = – 0.265, p = 0.026), and oxygen desaturation index (r = – 0.254, p = 0.031).

Conclusion: We concluded that EDS seen in some of the OSAS patients might be associated with various pathophysiologic mechanisms including substance P levels.

Key Words: obstructive sleep apnea syndrome • sleepiness • substance P






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