Abstract

Abstract Introduction Growing evidence suggests the contribution of obstructive sleep apnea (OSA) in the molecular pathways of aging related to the maintenance of telomere length. The present study aimed to investigate the effect of OSA and its treatment with continuous positive airway pressure (CPAP) on the variation of telomere length and its associated mechanisms. Methods For this, a 6-month randomized, double-blind and sham-controlled clinical trial was conducted. Participants were randomized to CPAP or sham-CPAP and attended 7 visits, in which they underwent clinical assessment and had their blood collected to determine mean leukocyte telomere length (LTL) and the dosage of metabolic and inflammatory markers. Results Among 127 individuals that we contacted, 46 met the inclusion criteria. At baseline, individuals in both groups were homogeneous, including LTL (p=0.106). Adherence during the intervention was 5.29 ± 1.09 in the sham-CPAP group and 5.71 ± 0.19 in the CPAP group. After 6 months of intervention, we observed a statistically significant effect of the treatment (p=0.001) on LTL, in which the sham-CPAP group (1.0117 ± 0.1552, 0.9457 ± 0.0747, 0.8482 ± 0.2163) showed a more significant reduction than the CPAP group (1.0960 ± 0.1122, 1.0521 ± 0.1094, 1.0675 ± 0.1225). Furthermore, we found a negative correlation between delta LTL and dela TNF-α at Visit 7 and Visit 1 (rho=-0.216, p=0.003) due to the sham-CPAP intervention (rho=-0.383, p=0.009) in relation to the use of CPAP (rho=0.021, p=0.800). Conclusion We can conclude that CPAP, when compared to sham-CPAP placebo, caused an effect on LTL stability, potentially by the modulation of TNF-α. Support (if any) Our studies are supported by Associação Fundo de Incentivo à Pesquisa (AFIP), Fundação de Amparo à Pesquisa de São Paulo (FAPESP), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and Conselho Nacional de Desenvolvimento Científico Tecnológico (V.A. and S.T. received CNPq fellowships).

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