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Hematocrit levels in sleep apnea

V Hoffstein1, M Herridge, S Mateika

  • 1Department of Medicine, St. Michael's Hospital, University of Toronto, Ontario.

Chest
|September 1, 1994
PubMed
Summary

Patients with obstructive sleep apnea (OSA) have slightly higher hematocrit levels, but intermittent nocturnal hypoxemia does not cause significant polycythemia. These minor hematocrit elevations are not reliable markers for hypoxic stress in OSA patients.

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Area of Science:

  • Sleep Medicine
  • Hematology
  • Pulmonology

Background:

  • Obstructive sleep apnea (OSA) is characterized by recurrent nocturnal oxygen desaturation.
  • The relationship between intermittent hypoxemia in OSA and hematocrit levels requires further elucidation.
  • Hematocrit elevation (polycythemia) is a potential compensatory response to chronic hypoxia.

Purpose of the Study:

  • To test the hypothesis that patients with OSA have higher hematocrit levels compared to nonapneic individuals.
  • To investigate the association between nocturnal oxygenation indices and hematocrit levels in patients with suspected OSA.

Main Methods:

  • Prospective study of 624 patients referred for suspected sleep apnea.
  • Nocturnal polysomnography to assess sleep and oxygenation (TST85%, LoSaO2, MnSaO2).

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  • Measurements included hematocrit, hemoglobin, WBC, and platelet counts; smoking history and awake SaO2 were recorded.

    • Main Results:

    • Patients with higher percentages of time with oxygen saturation below 85% (TST85%) showed minimally higher hematocrit levels.
    • Multiple linear regression identified mean nocturnal SaO2, age, and smoking pack-years as significant predictors of hematocrit.
    • These factors explained only 9% of the variability in hematocrit levels, indicating a weak association.

    Conclusions:

    • Intermittent nocturnal hypoxemia in OSA is associated with minor elevations in hematocrit, not clinical polycythemia.
    • These small hematocrit changes are unlikely to serve as clinically useful markers of hypoxic stress in OSA.
    • Further research may be needed to understand the full hematological impact of OSA.