The Relationship of Hemogram Parameters and Night Desaturation in Patients Diagnosed with Obstructive Sleep Apnea Syndrome
PDF
Cite
Share
Request
Original Article
P: 62-66
September 2018

The Relationship of Hemogram Parameters and Night Desaturation in Patients Diagnosed with Obstructive Sleep Apnea Syndrome

J Turk Sleep Med 2018;5(3):62-66
1. Denizli Devlet Hastanesi, Göğüs Hastalıkları Kliniği, Denizli, Türkiye
2. Pamukkale Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Denizli, Türkiye
3. Pamukkale Üniversitesi Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Denizli, Türkiye
No information available.
No information available
Received Date: 25.07.2018
Accepted Date: 17.10.2018
Publish Date: 13.12.2018
PDF
Cite
Share
Request

ABSTRACT

Objective:

Obstructive Sleep Apnea syndrome (OSAS) is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper respiratory tract obstructions episodes during sleep and often a decrease in blood oxygen saturation. Night hypoxias and sympathetic activity increase of arousals in OSAS are thought to stimulate that endothelial dysfunction and hypercoagulability.

Materials and Methods:

In this study, it was aimed to evaluate the relationship between the severity of the disease and the night hypoxia severity with hemogram parameters in patients diagnosed with OSAS who examined in our clinics. A total of 94 cases were included in the study, including 24 controls, 24 mild, 23 moderate, and 23 severe OSAS.

Results:

The mean and minimum oxygen saturation values in polisomnography with the number of neutrophils and neutrophil/lymphocyte (N/L) ratio were negatively correlated in the mild and severe OSAS groups. A negative correlation was observed between erythrocyte distribution width (EDW) and, mean oxygen saturation and minimum oxygen saturation in moderate and severe OSAS. When the mean and minimum oxygen saturation with regression analysis of EDW and N/L ratio were examined in each three groups; the 1 unit decrease in the minimum oxygen saturation increases the N/L ratio by 0.5-fold (p=0.02) in the mild OSAS, 0.5-fold (p=0.01) in the severe OSAS and it increases the EDW by ratio 0.5-fold (p=0.02) in the moderate OSAS. The 1 unit decrease in the mean oxygen saturation increases the N/L ratio by 0.4-fold (p=0.04) and the EDW by 0.8-fold (p=0.001) in the severe OSAS.

Conclusion:

As long as the OSAS severity increases, it is determined that the hematocrit values of patients increasing. However, as patients’ sleep desaturation increase, we can see that EDW, the number of neutrophils, and N/L ratio also increasing. This situation suggests that the local inflammation caused by both mechanical stress and ischemia-reperfusion cycles in the respiratory tract in OSAS is a consequence of spillage into the systemic circulation.

Keywords: Obstructive Sleep Apnea syndrome, night desaturation, hematocrit, erythrocyte distribution width, neutrophil/lymphocyte ratio, mean platelet volume

References

1
American Academy of Sleep Medicine. ICSD-2: The International Classification of Sleep Disorders. Diagnostic and Coding Manual, Ed.2, Westchester, Illinois: AASM, 2005.
2
http://www.toraks.org.tr/book.aspx?list=1378&menu=237
3
McNicholas WT, Bonsigore MR. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J 2007;29:156-78.
4
Zamarron C, Garcia Paz V, Riveiro A. Obstructive sleep apnea syndrome is a systemic disease. Current evidence. Eur J Intern Med 2008;19:390-8.
5
Thompson CB, Eaton KA, Princiotta SM, Rushin CA, Valeri CR. Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity, and function. Br J Haematol 1982;50:509-19.
6
Kondo Y, Kuwahira I, Shimizu M, Nagai A, Iwamoto T, Kato S, Hayama N, Aoki T, Urano T, Yoshii F, Kobayashi H, Abe T. Significant relationship between platelet activation and apnea-hypopnea index in patients with obstructive sleep apnea syndrome. Tokai J Exp Clin Med 2011;36:79-83.
7
Erden EŞ, Yengil E, Tuncel E, Bilgiç HY, Demirköse M, Motor S, Genç S. Obstrüktif uyku apne sendromu ile ortalama trombosit hacmi arasındaki ilişkinin incelenmesi. J Clin Exp Invest 2013;4:492-6.
8
Sökücü SN, Özdemir C, Dalar L, Karasulu L, Aydın F, Altın S. Is Mean Platelet Volume Really a Severity Marker for Obstructive Sleep Apnea Syndrome without Comorbidities? Pulm Med 2014;2014:754839.
9
Pack AI, Gislason T. Obstructive sleep apnea and cardiovascular disease: a perspective and future directions. Prog Cardiovasc Dis 2009;51:434-51.
10
Ozsu S, Abul Y, Gulsoy A, Bulbul Y, Yaman S, ds Ozlu T. Red cell distribution width in patients with obstructive sleep apnea syndrome. Lung 2012;190:319-26.
11
Iber C, Ancoli-Israel S, Chesson A, et al. American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1 st ed. Westchester, IL: American Academy of Sleep Medicine; 200
12
Akyol S, Çörtük M, Baykan AO, Kiraz K, Börekçi A, Şeker T, Gür M, Çayli M. Mean platelet volume is associated with disease severity in patients with obstructive sleep apnea syndrome. Clinics (Sao Paulo) 2015;70:481-5.
13
Dunleavy M, Dooley M, Cox D, Bradford A. Chronic intermittent asphyxia increases platelet reactivity in rats. Exp Physiol 2005;90:411-6.
14
Akyüz A, Akkoyun DÇ, Oran M, Değirmenci H, Alp R. Mean Platelet Volume in Patients with Obstructive Sleep Apnea and Its Relationship with Simpler Heart Rate Derivatives. Cardiol Res Pract 2014;2014:454701.
15
Williams A, Scharf SM. Obstructive sleep apnea, cardiovascular disease, and inflammation--is NF-kappaB the key? Sleep Breath 2007;11:69-76.
16
Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005;352:1011-23.
17
Libby P, Ridker PM, Maseri A. Inflamation and aterosclerosis. Circulation 2002;105:1135-43.
18
Dabbah S, Hammerman H, Markiewicz W, Aronson D. Relation between red cell distribution width and clinical outcomes after acute myocardial infarction. Am J Cardiol 2010;105:312-7.
19
Sökücü SN, Karasulu L, Dalar L, Seyhan EC, Altın S. Can red blood cell distribution width predict severity of obstructive sleep apnea syndrome? J Clin Sleep Med 2012;8:521-5.
20
Karakaş MS, Er A, Gülcan AR, Altekin RE, Yalçınkaya S, Çilli A. Assesment of Red Cell Distribution Width (RDW) in Patients With Obstructive Sleep Apnea Syndrome. J Turgut Ozal Med Cent 2013:20:208-14.
21
Gunbatar H, Sertogullarindan B, Ekin S, Akdag S, Arisoy A, Sayhan H. The correlation between red blood cell distribution width levels with the severity of obstructive sleep apnea and carotid intima media thickness. Med Sci Monit 2014;20:2199-204.
22
Rubinstein I. Nasal inflammation is present in patients with obstructive sleep apnea. Laryngoscope 1995;105:175-7.
23
Sekosan M, Zakkar M, Wenig B. Inflammation is present in the uvula mucosa of patients with obstructive sleep apnea. Laryngoscope 1996;106:1018-20.
24
Salerno FG, Carpagnano E, Guido P, Bonsignore MR, Roberti A, Aliani M, Vignola AM, Spanevello A. Airway inflammation in patients affected by obstructive sleep apnea syndrome. Respir Med 2004;98:25-8.
25
Carpagnano GE, Kharitonov SA, Resta O, Foschino-Barbaro MP, Gramiccioni E, Barnes PJ. Increased 8-isoprostane and interleukin-6 in breath condensate of obstructive sleep apnea patients. Chest 2002;122:1162-7.
2024 ©️ Galenos Publishing House