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

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.