{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:22:16Z","timestamp":1789996936410,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,11,18]],"date-time":"2016-11-18T00:00:00Z","timestamp":1479427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Clinical Research Priority Program Sleep and Health of the University of Zurich"},{"name":"NIHR Biomedical Research Centre Oxford"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2017,5]]},"abstract":"\nABSTRACT<\/jats:styled-content>\n<\/jats:title>Background and objective<\/jats:title>Obstructive sleep apnoea (OSA<\/jats:styled-content>) is associated with cardiovascular disease. Intermittent hypoxia, endothelial dysfunction and adipose tissue\u2010mediated inflammation have all been linked to cardiovascular disease in OSA<\/jats:styled-content>. We therefore explored the effect of OSA<\/jats:styled-content> on relevant associated blood markers: adrenomedullin (ADM<\/jats:styled-content>), endocan, endothelin\u20101 (ET<\/jats:styled-content>\u20101), resistin and vascular endothelial growth factor (VEGF).<\/jats:p><\/jats:sec>Methods<\/jats:title>Patients with OSA<\/jats:styled-content>, established on and compliant with continuous positive airways pressure (CPAP<\/jats:styled-content>) therapy for >1\u2009year were included from three randomized controlled trials, conducted at two centres. Patients were randomized to either continued therapeutic CPAP<\/jats:styled-content> or sham CPAP<\/jats:styled-content> (CPAP<\/jats:styled-content> withdrawal) for 2 weeks. Blood markers were measured at baseline and at 14 days and the treatment effect between sham CPAP<\/jats:styled-content> and therapeutic CPAP<\/jats:styled-content> was analysed.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 109 patients were studied (therapeutic CPAP<\/jats:styled-content> n<\/jats:italic>\u2009=\u200954, sham CPAP<\/jats:styled-content> n<\/jats:italic>\u2009=\u200955). Sham CPAP<\/jats:styled-content> was associated with a return of OSA<\/jats:styled-content> (between\u2010group difference in oxygen desaturation index (ODI<\/jats:styled-content>) 36.0\/h, 95% CI<\/jats:styled-content> 29.9\u201342.2, P<\/jats:italic>\u2009<\u20090.001). Sham CPAP<\/jats:styled-content> was associated with a reduction in ADM<\/jats:styled-content> levels at 14 days (\u221226.0\u2009pg\/mL<\/jats:styled-content>, 95% CI<\/jats:styled-content> \u221247.8 to \u22124.3, P<\/jats:italic>\u2009=\u20090.02), compared to therapeutic CPAP<\/jats:styled-content>. Return of OSA<\/jats:styled-content> was not associated with changes in endocan, ET<\/jats:styled-content>\u20101, resistin or VEGF.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Whilst CPAP<\/jats:styled-content> withdrawal was associated with return of OSA<\/jats:styled-content>, it was associated with an unexpected significant reduction in the vasodilator ADM<\/jats:styled-content> and not with expected increases in hypoxia\u2010induced markers, markers of endothelial function or resistin. We propose that the vascular effects occurring in OSA<\/jats:styled-content> may be brought about by other mechanisms, perhaps partly through a reduction in ADM<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.12946","type":"journal-article","created":{"date-parts":[[2016,11,18]],"date-time":"2016-11-18T09:27:44Z","timestamp":1479461264000},"page":"793-799","source":"Crossref","is-referenced-by-count":19,"title":["Effect of OSA<\/scp> on hypoxic and inflammatory markers during CPAP<\/scp> withdrawal: F<\/scp>urther evidence from three randomized control trials"],"prefix":"10.1111","volume":"22","author":[{"given":"Chris D.","family":"Turnbull","sequence":"first","affiliation":[{"name":"Oxford Centre for Respiratory Medicine Oxford University Hospitals NHS Foundation Trust Oxford UK"},{"name":"NIHR Oxford Biomedical Research Centre University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina A.","family":"Rossi","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Sleep Disorders Center University Hospital of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Santer","sequence":"additional","affiliation":[{"name":"NIHR Oxford Biomedical Research Centre University of Oxford Oxford UK"},{"name":"Department of Physiology, Anatomy and Genetics University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther I.","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Sleep Disorders Center University Hospital of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Stradling","sequence":"additional","affiliation":[{"name":"Oxford Centre for Respiratory Medicine Oxford University Hospitals NHS Foundation Trust Oxford UK"},{"name":"NIHR Oxford Biomedical Research Centre University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayia","family":"Petousi","sequence":"additional","affiliation":[{"name":"Oxford Centre for Respiratory Medicine Oxford University Hospitals NHS Foundation Trust Oxford UK"},{"name":"Nuffield Department of Medicine University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Kohler","sequence":"additional","affiliation":[{"name":"Division of Pulmonology and Sleep Disorders Center University Hospital of Zurich Zurich Switzerland"},{"name":"Center for Integrative Human Physiology University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199304293281704"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.55.9.736"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07445-7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71141-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201106-0964OC"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0179"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2010.145"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2006.00498.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01402.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-199917010-00010"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4180"},{"key":"e_1_2_7_13_1","first-page":"50","article-title":"Association of elevated levels of vascular endothelial growth factor in obstructive sleep apnea syndrome with patient age rather than with obstructive sleep apnea syndrome severity","volume":"74","author":"Peled N","year":"2007","journal-title":"Respir. 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