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Erythropoietin and obstructive sleep apnea
Mikolaj Winnicki1, Abu Shamsuzzaman, Paola Lanfranchi
1Medical University of Gdansk, Gdansk, Poland.
American Journal of Hypertension
|September 15, 2004
Summary
Severe obstructive sleep apnea increases erythropoietin levels, a hormone that stimulates red blood cell production. Continuous positive airway pressure treatment effectively reduces these elevated erythropoietin levels.
Area of Science:
- Sleep Medicine
- Endocrinology
- Cardiovascular Research
Background:
- Obstructive sleep apnea (OSA) is characterized by repetitive episodes of severe hypoxemia.
- Hypoxemia is a known stimulus for erythropoietin (EPO) production.
- The relationship between OSA severity, hypoxemia, and EPO levels requires further elucidation.
Purpose of the Study:
- To test if repetitive severe hypoxemia from OSA increases serum EPO.
- To determine if effective OSA treatment with continuous positive airway pressure (CPAP) attenuates this EPO increase.
Main Methods:
- Studied untreated patients with severe (n=18) and very mild (n=10) OSA, and 12 healthy controls.
- Measured serum EPO levels before and after acute treatment with CPAP in OSA patients.
- Compared EPO responses between OSA groups and controls over a 3.5-4 hour period.
Main Results:
- Baseline EPO levels were similar across groups.
- Severe OSA patients showed a 20% increase in EPO after untreated hypoxemia (lowest O2 77%).
- CPAP treatment significantly decreased EPO levels in severe OSA patients (P=.001), unlike controls or mild OSA patients.
Conclusions:
- Untreated severe OSA leads to elevated serum EPO levels.
- CPAP treatment reverses this EPO elevation in severe OSA.
- Increased EPO may be a reversible mechanism linking OSA to cardiovascular disease.