Sleep Medicine Reviews
Volume 7, Issue 1 , Pages 35-51 , February 2003

Obstructive sleep apnoea syndrome – an oxidative stress disorder

References 

  1. Lavie P, Herer P, Hoffstein V. Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study. BMJ. 2000;320:479–482
  2. Grote L, Hedner J, Peter JH. Sleep-related breathing disorder is an independent factor for uncontrolled hypertension. J Hypertens. 2000;18:679–685
  3. Shahar E, Whitney CW, Redline S. Sleep-disordered breathing and cardiovascular disease cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med. 2001;163:19–25
  4. Young T, Peppard PE, Palta M. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med. 1997;157:1746–1752
  5. Peppard P, Young , T , Palta , M , Skatrud , et al. Prospective study of the association between sleep disordered breathing and hypertension. N Engl J Med. 2000;342:1378–1384
  6. Nieto FJ, Young TB, Lind BK. Association of sleep disordered breathing, sleep apnea and hypertension in a large community-based study. JAMA. 2000;283:1829–1836
  7. De Olazabal JR, Miller MJ, Cook WR, Mithoefer JC. Disordered breathing and hypoxia during sleep in coronary artery disease. Chest. 1982;82:548–552
  8. Hung J, Whitford EG, Parsons RW, Hillman DR. Association of sleep apnoea with myocardial infarction in men. Lancet. 1990;336:261–264
  9. Saito T, Yoshikawa T, Sakamoto Y, Tanaka K, Inoue T, Ogawa R. Sleep apnea in patients with acute myocardial infarction. Am J Respir Crit Care Med. 1991;19:938–941
  10. Mooe T, Rabben T, Wiklund U, Franklin KA, Eriksson P. Sleep-disordered breathing in men with coronary artery disease. Chest. 1996;109:659–663
  11. Bassetti C, Aldrich MS, Chervin RD, Quint D. Sleep apnea in patients with transient ischemic attack and stroke: a prospective study of 59 patients. Neurology. 1996;47:1167–1173
  12. Xie A, Skatrud JB, Crabtree DC, Puleo DS, Goodman BM, Morgan BJ. Neurocirculatory consequences of intermittent asphyxia in humans. J Appl Physiol. 2000;89:1333–1339
  13. Leuenberger U, Jacob E, Sweer L, Waravdekar N, Zwillich C, Sinoway L. Surges of muscle sympathetic nerve activity during obstructive apnea are linked to hypoxaemia. J Appl Physiol. 1995;79:581–588
  14. Somers VK, Dyken ME, Clary MP, Abboud FM. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest. 1995;96:1897–1904
  15. Carlson JT, Hedner J, Elam M, Ejnell H, Sellgren J, Wallin BG. Augmented resting sympathetic activity in awake patients with obstructive sleep apnea. Chest. 1993;103:1763–1768
  16. Narkiewicz K, van de Borne PJ, Pesek CA, Dyken ME, Montano N, Somers VK. Selective potentiation of peripheral chemoreflex sensitivity in obstructive sleep apnea. Circulation. 1999;99:1183–1189
  17. Carlson JT, Rangemark C, Hedner JA. Attenuated endothelium-dependent vascular relaxation in patients with sleep apnoea. J Hypertens. 1996;14:577–584
  18. Imadojemu VA, Gleeson K, Gray KS, Sinoway LI, Leuenberger UA. Obstructive apnea during sleep is associated with peripheral vasoconstriction. Am J Respir Crit Care Med. 2002;165:61–66
  19. Dean RT, Wilcox I. Possible atherogenic effects of hypoxia during obstructive sleep apnea (Supplement: 2. Natural History of Sleep Apnea). Sleep. 1993;16:S15–S22
  20. Prabhakar RN. Physiologic and genomic consequences of intermittent hypoxia. Invited review: Oxygen sensing during intermittent hypoxia: cellular and molecular mechanisms. J Appl Physiol. 2001;90:1986–1994
  21. Droge W. Free radicals in the physiological control of cell function. Physiol Rev. 2002;82:47–95
  22. Babior BM. Phagocytes and oxidative stress. Am J Med. 2000;109:33–44
  23. McCord JM. The evolution of free radicals and oxidative stress. Am J Med. 2000;108:652–659
  24. Sen CK. Cellular thiols and redox-regulated signal transduction. Curr Top Cell Regul. 2000;36:1–30
  25. Halliwell B, Gutteridge JMC. Role of free radicals and catalytic metal ions in human disease: an overview. Meth Enzymol. 1990;186:1–85
  26. Beckman JS, Koppenol WH. Nitric oxide, superoxide, and peroxynitrite: the good, the bad, and the ugly. Am J Physiol. 1996;271:C1421–C1437
  27. Dureanteau J, Chandel NS, Kulisz A. Intracellular signaling by Reactive Oxygen Species during hypoxia in Cardiomyocytes. J Biol Chem. 1998;273:11619–11624
  28. Bouaziz N, Redon M, Quere L, Remacle J, Michiels C. Mitocondrial respiratory chain as a new target for anti-ischemic molecules. Eur J Pharmacol. 2002;441:35–45
  29. Sanders SP, Zweier JL, Kuppusamy P. Hyperoxic sheep pulmonary microvascular endothelial cells generate free radicals via mitochondrial electron transport. J Clin Invest. 1993;91:46–52
  30. Chandel NS, Maltepe E, Goldwasser E. Mitochondrial reactive oxygen species trigger hypoxia-induced transcription. Procl Natl Acad Sci USA. 1998;95:11715–11720
  31. Schulz R, Mahmoudi S, Katja Hattar . Enhanced release of superoxide form polymorphonuclear neutrophils in obstructive sleep apnea. Am J Respir Crit Care Med. 2000;162:566–570
  32. Dyugovskaya L, Lavie P, Lavie L. Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients. Am J Respir Crit Care Med. 2002;165:934–939
  33. Mohazzab KM, Kaminski PM, Wolin MS. NADH oxidoreductase is a major source of superoxide anion in bovine coronary artery endothelium. Am J Physiol. 1994;266:H2568–H2572
  34. Rajogopalan S, Kurz S, Munzel T. Angiotensin II mediated hypertension in the rat increases vascular superoxide production via membrane NADH/NADPH oxidase activation: contribution to alterations of vasomotor tone. J Clin Invest. 1996;97:1916–1923
  35. Griendling KK, Sorescu D, Ushio-Fukai M. NAD(P)H oxidase. Role in cardiovascular biology and disease. Circ Res. 2000;86:494–501
  36. Barcelo A, Elorza MA, Barbe F. Angiotensin converting enzyme in patients with sleep apnoea syndrome: plasma activity and gene polymorphisms. Eur Respir J. 2001;17:728–732
  37. Marshall C, Mamary AJ, Verhoeven AJ, Marshall BE. Pulmonary artery NADPH-oxidase is activated in hypoxic pulmonary vasoconstriction. Am J Resp Cell Mol Biol. 1996;15:633–644
  38. Fletcher EC, Bao G, Li R. Renin activity and blood pressure in response to chronic episodic hypoxia. Hypertension. 1999;34:309–314
  39. Fletcher EC. Physiological and genomic consequences of intermittent hypoxia. Invited review: Physiological consequences of intermittent hypoxia: systemic blood pressure. J Appl Physiol. 2001;90:1600–1605
  40. Fletcher EC, Orolinova N, Bader M. Blood pressure response to chronic episodic hypoxia: the renin-angiotensin system. J Appl Physiol. 2002;92:627–633
  41. McCord MJ. Oxygen derived free radicals in post ischemic tissue injury. New Engl J Med. 1985;312:159–163
  42. Bolli R, Jeroudi MO, Patel BS. Direct evidence that oxygen-derived free radicals contribute to postischemic myocardial dysfunction in the intact dog. Proc Natl Acad Sci USA. 1989;86:4695–4699
  43. Bolli R, Jeroudi MO, Patel BS. Marked reduction of free radical generation and contractile dysfunction by antioxidant therapy begun at the time of reperfusion. Evidence that myocardial “stunning” is a manifestation of reperfusion injury. Circ Res. 1989;65:607–622
  44. Villari B, Ambrosio G, Golino P. The effects of calcium channel antagonist treatment and oxygen radical scavenging on infarct size and the no-reflow phenomenon in reperfused hearts. Am Heart J. 1993;125:11–23
  45. Jolly SR, Kane WJ, Bailie MB. Canine myocardial reperfusion injury. Its reduction by the combined administration of superoxide dismutase and catalase. Circ Res. 1984;54:277–285
  46. Terada LS, Dormish JJ, Shanley PF, Leff JA, Anderson BO, Repine JE. Circulating xanthine oxidase mediates lung neutrophil sequestration after intestinal ischaemia-reperfusion. Am J Physiol. 1992;263:L394–L401
  47. Terada LS, Guidot DM, Leff JA. Hypoxia injures endothelial cells by increasing endogenous xanthine oxidase activity. Proc Natl Acad Sci USA. 1992;89:3362–3366
  48. Findley LJ, Boykin M, Fallon T, Belardinelli L. Plasma adenosine and hypoxaemia in patients with sleep apnea. J Appl Physiol. 1988;64:556–561
  49. Mann J, Holgate S, Renwick A, Cushley M. Airway effects of purine nucleosides and nucleotides and release with bronchial provocation in asthma. J Appl Physiol. 1986;61:1667–1676
  50. Sollevi A. Cardiovascular effects of adenosine in man; possible clinical implications. Prog Neurobiol. 1986;27:319–349
  51. Eldridge FL, Millhorn DE, Kiley JP. Antagonism by theophylline of respirator inhibition induced by adenosine. J Appl Physiol. 1985;59:1428–1433
  52. Mueller RA, Widerlov E, Breese GR. Attempted anta-gonism of adenosine analogue induced depression of respiration. Pharmacol Biochem Behav. 1984;21:289–296
  53. Hasday JD, Grum CM. Nocturnal increase of urinary uric acid: creatinine ratio. A biochemical correlate of sleep-associated hypoxaemia. Am Rev Respir Dis. 1987;135:534–538
  54. McKeon JL, Saunders NA, Murree-Allen K. Urinary uric acid: creatinine ratio, serum erythropoietin, and blood 2,3-diphosphoglycerate in patients with obstructive sleep apnea. Am Rev Respir Dis. 1990;142:8–13
  55. Braghiroli A, Sacco C, Erbetta M. Overnight urinary uric acid: Creatinine ratio for detection of sleep hypoxaemia. Validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treatment with nasal continuous positive airway pressure. Am Rev Respir Dis. 1993;148:173–178
  56. Sahebjani H. Changes in urinary uric acid excretion in obstructive sleep apnea before and after therapy with nasal continuous positive airway pressure. Chest. 1998;113:1604–1608
  57. Semenza GL. Oxygen-regulated transcription factors and their role in pulmonary disease. Respir Res. 2000;1:159–162
  58. Piacentini L, Karliner JS. Altered gene expression during hypoxia and reoxygenation of the heart. Pharmacol Ther. 1999;83:21–37
  59. Yuan G, Adhikary G, Prabhakar NR. Activation of HIF-2a by intermittent hypoxia requires CaMKII (Abstract). FASEB J. 2001;15:A154
  60. Imagawa S, Yamaguchi Y, Higuchi M. Levels of vascular endothelial growth factor are elevated in patients with obstructive sleep apnea-hypopnea syndrome. Blood. 2001;98:1255–1257
  61. Schulz R, Hummel C, Heinemann S. Serum levels of vascular endothelial growth factor are elevated in patients with obstructive sleep apnea and severe nighttime hypoxia. Am J Respir Crit Care Med. 2002;165:67–70
  62. Gozal D, Lipton AJ, Jones KL. Circulating vascular endothelial growth factor levels in patients with obstructive sleep apnea. Sleep. 2002;25:59–65
  63. Lavie L, Kraiczi H, Hefetz . Plasma Vascular Endothelial Growth Factor (VEGF) in sleep apnea syndrome: effects of nCPAP treatment. Am J Respir Crit Care Med. 2002;165:1624–1628
  64. Schultz A, Lavie L, Hochberg I. Interindividual heterogeneity in the hypoxic regulation of VEGF: significance for the development of the coronary artery collateral circulation. Circulation. 1999;100:547–552
  65. Gunsilius E, Petzer AL, Gastl GA. Blood levels of vascular endothelial growth factor in obstructive sleep apnea-hypopnea syndrome. (Letter to Editor). Blood. 2002;99:393–394
  66. Webb NJ, Bottomley MJ, Watson CJ, Brenchley PE. Vascular endothelial growth factor (VEGF) is released from platelets during blood clotting: implications for measurement of circulating VEGF levels in clinical disease. Clin Sci. 1998;94:395–404
  67. Carlson JT, Hedner J, Fagerber B. Secondary polycythaemia associated with nocturnal apnoea – a relationship not mediated by erythropoietin?. J Intern Med. 1992;231:381–387
  68. Pokala P, Llanera M, Sherwood J. Erythropoietin response in subjects with obstructive sleep apnea. Am J Respir Crit Care Med. 1995;151:1862–1865
  69. Cahan C, Decker MJ, Arnold JL. Diurnal variations in serum erythropoietin levels in healthy subjects and sleep apnea patients. J Appl Physiol. 1992;72:2112–2117
  70. Cahan C, Decker MJ, Arnold JL. Erythropoietin levels with treatment of obstructive sleep apnea. J Appl Physiol. 1995;79:1278–1285
  71. Knaupp W, Khilnani S, Sherwood J. Erythropoietin response to acute normobaric hypoxia in humans. J Appl Physiol. 1992;73:837–840
  72. Ehlenz K, Herzog P, von Wichert P, Kaffarnik H, Peter JH. Renal excretion of endothelin in obstructive sleep apnea syndrome. In:  Gautier C,  Escourrou P, Curzi-Dascalova  editor. Colloque IMSERM. 217:John Libbey Ltd; 1991;p. 226
  73. Saarelainen S, Seppala E, Laasonen K, Hasan J. Circulating endothelin-1 in obstructive sleep apnoea. Endothelium. 1997;5:115–118
  74. Phillips BG, Narkiewicz K, Pesek CA. Effects of obstructive sleep apnea on endolethelin-1 and blood pressure. J Hypertens. 1999;17:61–66
  75. Trakada G, Mnangos M, Spiropoulos K. Mechanisms of endothelin-1 elevation in chronic obstructive pulmonary disease patients with nocturnal oxyhaemoglobin desaturation. Respiration. 2001;68:134–139
  76. Tahawi Z, Orolinova N, Joshua IG. Altered vascular reactivity in arterioles of chronic intermittent hypoxic rats. J Appl Physiol. 2001;90:2007–2013
  77. Kanagy NL, Walker BR, Nelin LD. Role of endothelin in intermittent hypoxia-induced hypertension. Hypertension. 2001;37:511–515
  78. Grimpen F, Kanne P, Schulz E. Endothelin-1 plasma levels are not elevated in patients with obstructive sleep apnoea. Eur Respir J. 2000;15:320–325
  79. Saarelainen S, Hasan J. Circulating endothelin-1 and obstructive sleep apnoea. Eur Respir J. 2000;16:794–795
  80. Chin K, Ohi M, Shimzu K. Increase in bilirubin levels of patients with obstructive sleep apnea in the morning – a possible explanation of induced heme oxygenase-1. Sleep. 2001;24:218–223
  81. Vgontzas AN, Papanicolaou DA, Bixler EO. Elevation of plasma cytokines in disorders of excessive daytime sleepiness: role of sleep disturbances and obesity. J Clin Endocrinol Metab. 1997;82:1313–1316
  82. Vgontzas AN, Papanicolaou DA, Bixler EO. Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance and hypercytokinemia. J Clin Endocrinol Metab. 2000;85:1151–1158
  83. Entzian P, Linnemann K, Schlaak M, Zabel P. Obstructive sleep apnea syndrome and circadian rhythms of hormones and cytokines. Am J Respir Crit Care Med. 1996;153:1080–1086
  84. Chin K, Nakamura T, Shimzu K. Effects of nasal continuous positive airway pressure on soluble cell adhesion molecules in patients with obstructive sleep apnea syndrome. Am J Med. 2000;109:562–567
  85. Ohga E, Nagase T, Tomita T. Increased levels of circulating ICAM-1, VCAM-1, and L-selectin in obstructive sleep apnea syndrome. J Appl Physiol. 1999;87:10–14
  86. El-Solh AA, Mador MJ, Sikka P, Dhillon RS, Amsterdam D, Grant BJ. Adhesion molecules in patients with coronary artery disease and moderate-to-severe obstructive sleep apnea. Chest. 2002;121:1541–1547
  87. Sen CK. Redox signaling and the emerging therapeutic potential of thiol antioxidants. Biochem Pharmacol. 1998;55:1747–1758
  88. Noguchi T, Chin K, Ohi M. Heat shock protein 72 level decreases during sleep in patients with obstructive sleep apnea syndrome. Am J Respir Crit Care Med. 1997;155:1316–1322
  89. Lavie L, Ghandour H, Pillar G, Lavie P. Production of heat shock protein 70 by peripheral blood monocytes from patients with sleep apnea syndrome. J Sleep Res. 1998;7:150
  90. Ghandour H, Lavie P, Lavie L. Expression of heat shock proteins in obstructive sleep apnea syndrome. Sleep. 1999;22:S331
  91. Forgione MA, Leopold JA, Loscalzo J. Roles of endothelial dysfunction in coronary artery disease. Curr Opin Cardiol. 2000;15:409–415
  92. Grisham MB, Granger DN, Lefer DJ. Modulation of leukocyte-endothelial interactions by reactive metabolites of oxygen and nitrogen: relevance to ischemic heart disease. Free Radic Biol Med. 1998;25:404–433
  93. Walzog B, Gaehtgens P. Adhesion molecules: the path to a new understanding of acute inflammation. News Physiol Sci. 2000;15:107–113
  94. Panes J, Granger DN. Leukocyte-endothelial cell interactions: molecular mechanisms and implications in gastrointestinal disease. Gastroenterology. 1998;114:1066–1090
  95. Tailor A, Granger DN. Role of adhesion molecules in vascular regulation and damage. Curr Hypertens Rep. 2000;2:78–83
  96. Rairigh RL, Storme L, Parker TA. Role of neuronal nitric oxide synthase in regulation of vascular and ductus arteriosus tone in the ovine fetus. Am Physiol Lung Cell Mol Physiol. 2000;278:L105–L110
  97. Rairigh RL, Le Cras TD, Ivy DD. Role of inducible nitric oxide synthase in regulation of pulmonary vascular tone in the late gestation ovine fetus. J Clin Invest. 1998;101:15–21
  98. Hoffmann A, Gloe T, Pohl U. Hypoxia-induced upregulation of eNOS gene expression is redox-sensitive: a comparison between hypoxia and inhibitors of cell metabolism. J Cell Physiol. 2001;188:33–44
  99. Phelan MW, Faller DV. Hypoxia decreases constitutive nitric oxide synthase transcript and protein in cultured endothelial cells. J Cell Physiol. 1996;167:469–476
  100. Faller DV. Endothelial cell responses to hypoxic stress. Clin Exp Pharmacol Physiol. 1999;26:74–84
  101. Schulz R, Schmidt D, Blum A. Decreased plasma levels of nitric oxide derivative in obstructive sleep apnoea: response to nCPAP therapy. Thorax. 2000;55:1046–1051
  102. Ip MS, Lam B, Chan LY. Circulating nitric oxide is suppressed in obstructive sleep apnea and is reversed by nasal continuous positive airway pressure. Am J Respir Crit Care Med. 2000;162:2166–2171
  103. Carlson J, Hedner J, Patterson A. Increased plasma concentration of ADMA a naturally occurring nitric oxide synthesis inhibitor in OSA patients. Am J Respir Crit Care Med. 1997;155:A869
  104. Ross R. Atherosclerosis – an inflammatory disease. New Eng J Med. 1999;340:115–126
  105. Steinberg D. Low density lipoprotein oxidation and its pathological significance. J Biol Chem. 1997;272:20963–20966
  106. Koo JC, Miller E, McLoughlin P, Steinberg D. Enhanced macrophage uptake of low density lipoprotein after self-aggregation. Arteriosclerosis. 1988;8:348–358
  107. Navab M, Berliner JA, Watson AD. The Yin and Yang of oxidation in the development of the fatty streak: a review based on the 1994 George Lyman Duff Memorial Lecture. Arterioscler Thromb Vasc Biol. 1996;16:831–842
  108. Morel DW, Hessler JR, Chisholm GM. Low density lipoprotein cytotoxicity induced by free radical peroxidation of lipid. J Lipid Res. 1983;24:1070–1076
  109. Griendling KK, Alexander RW. Oxidative stress and cardiovascular disease. Circulation. 1997;96:3264–3265
  110. Wali SO, Bahammam AS, Massaeli H. Susceptibility of LDL to oxidative stress in obstructive sleep apnea. Sleep. 1998;21:290–296
  111. Saarelainen S, Lehtimaki T, Jaak-kola O. Autoantibodies against oxidised low-density lipoprotein in patients with obstructive sleep apnoea. Clin Chem Lab Med. 1999;37:517–520
  112. Salonen JT, Yla-Herttuala S, Yamamoto R. Autoantibody against oxidized LDL and progression of carotid atherosclerosis. Lancet. 1992;339:899–900
  113. Barcelo A, Miralles C, Barbe F, Vila M, Pons S, Agusti AG. Abnormal lipid peroxidation in patients with sleep apnoea. Eur Respir J. 2000;16:644–647
  114. McCully KS. Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis. Am J Pathol. 1969;56:111–128
  115. Graham IM, Daly EL, Refsum HM. Plasma homocysteine as a risk factor for vascular disease; The European concerted action project. JAMA. 1997;277:1775–1781
  116. Boushey CJ, Beresford SAA, Omenn GS. A qualitative assessment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intakes. JAMA. 1995;274:1049–1957
  117. Nygard O, Nordrehaug JE, Refsum H. Plasma homocysteine levels and mortality in patients with coronary artery disease. N Engl J Med. 1997;337:230–236
  118. Lentz SR, Sobey CG, Piegors DJ. Vascular dysfunction in monkeys with diet-induced hyperhomocyst(e)inemia. J Clin Invest. 1996;98:24–29
  119. Tawakol A, Omland T, Garhard W, Wu JT, Creager MA. Hyperhomocyst(e)inemia is associated with impaired endothelium-dependent vasodilation in humans. Circulation. 1997;95:1119–1121
  120. Bellamy MF, McDowell IF, Ramsey MW. Hyperhomocysteinemia after an oral methionine load acutely impairs endothelial function in healthy adults. Circulation. 1998;1848–1852
  121. Chambers JC, McGregor A, Jean-Marie J, Obeid OA, Kooner JS. Demonstration of rapid onset vascular endothelial dysfunction after hyperhomocysteinemia: an effect reversible with vitamin C therapy. Circulation. 1999;99:1156–1160
  122. Selhub J, Jacques PF, Bostom AG. Association between plasma homocysteine concentrations and extracranial carotid-artery stenosis. N Engl J Med. 1995;332:286–291
  123. Loscalzo J. The oxidant stress of hyperhomocyst(e)inemia. J Clin Invest. 1996;98:5–7
  124. Heinecke JW, Rosen H, Sukuki LA, Chait A. The role of sulfur-containing amino acids in superoxide production and modification of low density lipoprotein by arterial smooth muscle cells. J Biol Chem. 1987;262:10098–10103
  125. Eberhardt RT, Forgione MA, Cap A. Endothelial dysfunction in a murine model of mild hyperholocyst(e)inemia. J Clin Invest. 2000;106:483–491
  126. Lavie L, Perelman A, Lavie P. Plasma homocysteine levels in obstructive sleep apnea: association with cardiovascular morbidity. Chest. 2001;120:900–908
  127. Joannides R, Haefeli WE, Linder L. Nitric oxide is responsible for flow dependent dilation of human peripheral conduit arteries in vivo. Circulation. 1995;91:1314–1319
  128. Celermajer DS, Sorensen KE, Gouch VM. Non invasive detection of endothelial dysfunction in children and in adults at risk of atherosclerosis. Lancet. 1992;340:1111–1115
  129. Kato M, Roberts-Thomson P, Phillips BG. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation. 2000;102:2607–2610
  130. Kraiczi H, Caidahl K, Samuelsson A, Peker Y, Hedner J. Impairment of vascular endothelial function and left ventricular filling: association with the severity of apnea-induced hypoxaemia during sleep. Chest. 2001;119:1085–1091

PII: S1087-0792(02)90261-3

doi: 10.1053/smrv.2002.0261

Sleep Medicine Reviews
Volume 7, Issue 1 , Pages 35-51 , February 2003

Article Tools