The Severity of Obstructive Sleep Apnea Syndrome is related to Red Cell Distribution Width and Hematocrit Values

Abstract

Background: Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder characterized by recurrent upper airway collapse during sleep. Recently, some hematological parameters as red cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) have been emerged as inflammatory biomarkers. Limited, controversial data is available on the association between these hematological parameters and the severity of OSAS. Therefore, we aimed to investigate the levels of these parameters in patients with OSAS and its correlation with the severity of OSAS. Methods: The clinical data, polysomnography and laboratory results of complete blood pictures of 116 patients with OSAS were retrospectively collected and statistically analyzed. Results: Obstructive sleep apnea syndrome was associated with increased levels of hematocrit, RDW, MPV, PDW, and platelets count. RDW is positively correlated with Apnea-hypopnea index, oxygen desaturation index, Epworth sleepiness scale, and negatively correlated with minimum oxygen saturation and rapid eye movement sleep. Conclusion: RDW may be a marker for the severity of OSAS. As RDW is included in a complete blood count, it could provide an easy, inexpensive tool for triaging OSAS patients for polysomnography evaluation.

Role of Ultrasonography in Assessment of Anatomic Upper Airway Changes in Patients with Obstructive Sleep Apnea

“…Regarding the comparison between OSA patients and controls in polysomnography and neck ultrasonography data, our results were consistent with Bidarian-Moniri et al [21], who found altered AHI depending on the position and were in accordance with Yousef and Alkhiary [22] who reported significantly higher oxygen desaturation index and significantly lower minimal oxygen saturation in OSA patients than controls. As expected, AHI demonstrated significantly higher values in OSA patients than controls in this study (mean ± SD = 32.05 ± 22.79; vs mean ± SD = 1.63 ± 1.64; P < 0.001).…”

CPAP Influence on Readily Available Inflammatory Markers in OSA—A Pilot Study

“…RDW has been previously correlated with CRP and ESR values [ 15 ] and has been nominated as an index for estimating autoimmune disease activity [ 16 ] and a marker of subclinical inflammation, underlying atherosclerosis [ 15 ] and cardiovascular morbi-mortality [ 17 ]. OSA-induced repetitive hypoxia promotes accelerated erythropoiesis [ 43 ] which could explain a higher RDW in OSA [ 15 , 17 , 18 , 43 , 56 ]. Durmaz et al [ 57 ] have previously shown that RDW is a predictor of OSA burden in severe OSA patients.…”

“…Durmaz et al [ 57 ] have previously shown that RDW is a predictor of OSA burden in severe OSA patients. RDW values were previously correlated with AHI, DI, minimal nocturnal O2Sa and ESS results [ 18 , 58 , 59 , 60 , 61 ], suggesting that RDW could be used as an OSA screening tool in the general population. However, CPAP therapy seems to have little impact on RDW values [ 17 , 43 , 44 ]: while Leon Subias et al reported no changes in RDW after 1 year of CPAP [ 17 ], two other studies surprisingly reported an increase in RDW after 3–6 months of CPAP [ 43 , 62 ].…”

“…RDW has been nominated as an index for estimating autoimmune disease activity [ 16 ], a marker of subclinical inflammation and underlying atherosclerosis [ 15 ] and of increased cardiovascular morbi-mortality [ 17 ]. Furthermore, as RDW correlates with several OSA severity parameters, it could be viewed as a rudimentary OSA screening tool in the general population [ 18 ].…”