What is the blood abnormality seen with OSA?

[kteague]

I remember reading on here about some abnormality of blood cells sometime seen with untreated severe apnea. Does anyone remember the name of that abnormality? A friend with severe untreated apnea is recently undergoing testing on her blood and was I wondering if there is any possible correlation I should mention to her to have them investigate.

[BlackSpinner]

there is a lot of infohere about the adaption of the body to lower O2 levels.

Increased Red Blood Cell Production
Continuous oxygen deprivation eventually causes the body to increase red blood cell production (from 5 million/cm3 at sea-level to 8 million/cm3 at 4000 m).

Change in Oxygen Affinity of Blood
At altitude, humans experience a slight decrease in the oxygen affinity of blood which facilitates gas delivery to tissues at the expense of uptake in the lung. Additionally, higher levels of the 2, 3 Diphosphoglycerate (DPG) are found in humans at altitude. DPG is an organic phosphate that lowers the oxygen affinity of red blood cells. Finally, the rate of diffusion increases as levels of myoglobin, the oxygen carrying protein in red blood cells, in the blood rise.

[Loreena]

Sickle Cell:

http://www.methodisthealth.org/static/f ... .Final.pdf

[Julie]

Sickle cell anemia is vastly skewed to African Americans... very rare, if ever seen, in Caucasians, though with so many people now being somewhere in between, it's probably more of an issue.

[Sludge]

You may be thinking of polycythemia, but you've got to be REALLY bad (like Pickwickian) to get that:

http://www.ncbi.nlm.nih.gov/pubmed/16770648

http://journal.publications.chestnet.or ... id=1067906

[old dude]

My untreated AHI was 131 and likely had been for many, many years. I've had more blood tests that I could ever count but no doctor ever mentioned any blood abnormality in apnea patients. Given that I clearly present as an apnea patient, it would border on malpractice if a doctor saw me and filed to test for it.

I'd sure like to hear a definitive answer on this myself.

[SuddenlyWornOut45]

polycythemia vera...too many red blood cells. A high RBC count. I believe if it is caused by OSA, the polycythemia vera is considered "secondary polycythemia ver, because something else that is identifiable is causing it.

It mostly affects men, to my understanding.

Eric

[Julie]

Who it mostly affects are Meditarraneans, lots of Italians, definitely an old genetic trait.

I've never heard of any connection between apnea and blood disorders btw.

[SuddenlyWornOut45]

Uh, on this I know about. I have been briefed on it by my own doctors. Polycythemia vera can be caused by a lot of things. It can be purely genetic, it can also be caused by untreated OSA, it is a well known side effect of Testosterone Replacement Therapy and one of the biggest reasons men have to sometimes stop TRT. It can also be caused by too high iron levels. It can also be caused by totally morbid obesity...probably related to the severe OSA morbid obesity usually creates...chokes off your 02 supply.

You know why high altitude, technical mountain climbers come back to sea level and talk about all the "extra energy" they have? Its because the human body increases its red blood cell count when its at high altitudes for long periods as an adaptation and acclimatization. Of course, youve probably never heard of this before being a sedentary person as you sound, but mountain climbers are famous for coming back from the Rockies or the Himalayas or the Alps and when near sea level, exclaim, "geez, I feel like I have so much extra energy and am so much extra alert and can do cardio so much better." It usually lasts for about a week or two, in healthy, skinny mountain climbers...very few if any of whom have sleep apnea.

Eric

Who it mostly affects are Meditarraneans, lots of Italians, definitely an old genetic trait.

I've never heard of any connection between apnea and blood disorders btw.

[chunkyfrog]

Gee, and I thought my extra energy in the first couple of days was due to residual adrenaline.

[OhHelpMe]

Sickle cell anemia is vastly skewed to African Americans... ..

Do you know the logic error in this statement?

[Eureka]

Before being diagnosed with severe sleep apnia, I was undergoing all kinds of tests to find why I was suffering fatigue. At one point, my red blood count was over normal and my doctor suspected Polycythemia vera and sent me to a hematologist. When she tested my blood, it was at a normal level. I can't explain what happened to those counts. If the count was indeed over normal, my theory is that my body was starving for oxygen and as a defense mechanism it created either larger or more red blood cells to try to supply my oxygen needs. So I can see why apnea sufferers would be subject to having Polycythemia vera.

[Captain_Midnight]

Elevated RBC and hematocrit levels can suggest sleep apnea.

Mine were high, with an otherwise normal blood test. This blood test info was the key information that led to my sleep study.

Interestingly, it was less than a month after beginning xpap therapy that I re-did my bloodwork, and the two levels had completely normalized.

.

[JDS74]

I remember reading on here about some abnormality of blood cells sometime seen with untreated severe apnea. Does anyone remember the name of that abnormality?

The disorder is called hypercapnia and is a condition of elevated CO2 levels in the blood. Long term untreated OSA can lead to daytime hypercapnia and other complications.

Anyone with untreated or poorly treated sleep apnea considering surgery should be evaluated for this condition. It is a simple blood test called a comprehensive metabolic panel (CMP) and the particular sub-test is the CO2 level.

Frequently this is combined with a complete blood count (CBC) to give a more complete picture of what, if anything, is going on.

Both tests are very common for patients being admitted into a hospital situation.

My most recent test value was 22 mMol/L in a normal range of 19 -28 mMol/L for example.
It is sometimes measured in mm Hg with the normal range being 30-40 mm Hg and hypercapnia being values over 45 mm Hg.

Elevated CO2 levels result in the Hemoglobin in the red blood cells having a reduced capacity to carry oxygen from the lungs to the body's tissues. CO2 levels also control some types of breathing. Excessive CO2 levels can suppress breathing and can lead to unconsciousness and coma.

[kteague]

Thanks everyone for your replies. Will try to get a bit more info from my friend and see if any of it is something she needs to be made aware of. Thanks again. This reading has been quite informative.