Pharmacopsychiatry 2003; 36 - 141
DOI: 10.1055/s-2003-825392

Serum homocysteine in obstructive sleep apnea syndrome can be lowered by CPAP-therapy

W Jordan 1, C Berger 1, S Cohrs 1, A Rodenbeck 1, G Mayer 2, P Niedmann 3, E Rüther 1, S Bleich 4
  • 1Department of Psychiatry and Psychotherapy, Georg-August-University of Göttingen, Göttingen, Germany
  • 2Hephata Klinik, Schwalmstadt-Treysa, Germany
  • 3Department of Clinical Chemistry, Georg-August-University of Göttingen, Göttingen, Germany
  • 4Department of Psychiatry, Friedrich-Alexander-University of Erlangen-Nürnberg, Nürnberg, Germany

Obstructive sleep apnea patients (OSA) with ischemic heart disease or stroke have elevated plasma homocysteine levels, but serum total homocysteine (tHcy) concentrations in patients without severe cardio-/cerebrovascular pathology or the influence of treatment are unknown.

Therefore, serum tHcy and compounds of Hcy-metabolism were measured in untreated OSA patients and followed up during CPAP-treatment. Blood samples were taken in the evening, twice during sleep, in the morning, and one hour after awakening.

THcy levels in OSA followed a circadian pattern which was preserved under treatment. Two patients showed levels above 15µmol/l. Overall tHcy levels in patients were lowered about 30% by CPAP-treatment.

Dietary changes might contribute to the daily tHcy-variation, but an independent circadian rhythm cannot be excluded. The significant tHcy-reduction under treatment suggests that repeated apnea-related hypoxic events, e.g. oxidative stress, may enhance tHcy. CPAP-therapy is effective to lower tHcy and thus the increased (hyper)homocysteinemia-related risk for cardio-/cerebrovascular diseases.