The relationship of desaturation, oxidative stress, comorbid diseases, and conditions in obstructive sleep apnea syndrome

Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is associated with clinical pictures ranging from morning headache to vascular diseases and sudden death. It negatively affects the quality of life by causing deterioration in sleep quality, a decrease in work and academic performance caused by excessive daytime sleepiness (EDS), social restriction, and an increase in work/traffic accidents and depression. OSAS may cause comorbidities and conditions by desaturation. We aimed to investigate the effect of desaturation and cellular level hypoxia in patients with OSAS on comorbid diseases and conditions and emphasize their importance. Subjects and Methods: The study design was cross-sectional. A total of 100 patients (73 males and 27 females) aged 18-70 years were included in the study. Demographic data, presence of comorbidities (diabetes mellitus [DM], hypertension [HT], coronary artery disease), and symptoms related to OSAS (nocturia, enuresis, and morning headache) were questioned. In addition, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Scale were administered, the results of polysomnographic data were evaluated, and lactic acid levels were measured as an indicator of hypoxia at the cell level. Results: The minimum oxyhemoglobin saturation level was found to be associated with body mass index (BMI) (P = 0.004), HT (P = 0.005), ESS scores (P = 0.022), sleep apnea severity, depression scale (P = 0.012), position-related sleep apnea (P = 0.005), and lactic acid levels (P = 0.002). No correlation was found between sex, DM, CAD, morning headache, nocturia and enuresis, PSQI, and repaid eye movement -related sleep apnea. Conclusion: Although hypoxemia was shown to be associated with BMI, HT, EDS, depression, sleep apnea severity, positional apnea, and lactic acid in our study, sufficient evidence could not be obtained to consider the minimum oxyhemoglobin saturation level in the OSAS treatment plan. In the clinical evaluation of OSAS, apnea-hypopnea index and these parameters should be taken into account by physicians in the prediction of comorbidities and risks.