대한수면의학회

Objectives : Patients with obstructive sleep apnea syndrome(OSAS) often complain of nocturnal enuresis. There are a few reports that OSAS patients have altered renal function, and there are some evidences that the increased release of atrial natriuretic peptide(ANP) may be involved in the pathogenesis of nocturnal urinary symptoms of OSAS patients. In this study, we measured plasma ANP concentrations during waking and sleep in OSAS patients and normal controls to investigate whether there were differences of ANP concentrations between OSAS patients and normal subjects. Methods : 27 patients with OSAS and 10 normal subjects were studied. All subjects underwent a full-night polysomnographic study. Venous blood samples were separately drawn during waking and sleep. Plasma ANP concentrations were measured using radioimmunoassay. Results : In OSAS patients, ANP concentrations during sleep($122.9;{pm};29.9pg/ml$) were significantly higher than ANP concentrations during waking($60.2;{pm};5.8pg/ml$)(p < 0.05). However, in normal subjects, there was no significant difference between ANP concentrations during waking($59.2;{pm};5.7pg/ml$) and sleep($69.6;{pm};3.0pg/ml$)(p > 0.05). There was no significant difference of ANP concentrations during waking between OSAS patients($60.2;{pm};5.8pg/ml$) and normal controls($59.2;{pm};5.7pg/ml$)(p > 0.05), and also there was no significant difference during sleep between OSAS patients($122.9;{pm};29.9pg/ml$) and normal subjects($69.6;{pm};3.0pg/ml$)(p > 0.05). Plasma ANP concentrations during sleep showed significant positive correlations with apnea index(r = 0.3846, p < 0.05) and respiratory disturbance index(r = 0.3939, p < 0.05) in OSAS patients. Conclusion : These data suggest that, in OSAS patients, plasma ANP concentrations during sleep are significantly higher than plasma ANP concentrations during waking, and there is a positive correlation between the plasma ANP concentration during sleep and the severity of sleep apnea.

Obstructive Sleep Apnea Syndrome;Atrial Natriuretic Peptide(ANP);