The Link Between Sleep Apnea and Polycythemia: What You Need to Know

Sleep apnea is a relatively common condition in which your breathing stops and starts whilst you sleep. There are different types of sleep apnea, the most common of which is obstructive sleep apnea (OSA). This is when the upper airway collapses in your sleep making it difficult to breathe or creating pauses in your breaths. This can result in hypoxia, or low oxygen levels which overtime can cause a range of symptoms and if left untreated result in further complications. 

Research has shown that there is a possible link between OSA and polycythemia. Polycythemia, also known as erythrocytosis, is a blood disorder in which the body produces too many red blood cells. This causes the blood to thicken and increase in volume, making it flow less easily. It is thought that reduced levels of oxygen as a result of sleep apnea trigger the production of more red blood cells, and over time this results in polycythemia.

Understanding the link between sleep apnea and increased RBC count, is important for the effective management and treatment of both conditions to improve overall health and well being. 

Understanding Sleep Apnea and Its Types

Sleep apnea is a sleep-related breathing disorder which causes repeated pauses or reductions in breathing during sleep. This can occur throughout the night and reduces the quality of sleep.  It can reduce blood oxygen levels which means if left untreated over time sleep apnea can have significant health implications.

There are three main types of sleep apnea. The most common is obstructive sleep apnea or OSA. This occurs when the upper airways collapse in your sleep causing pauses in breathing. This could be as a result of obesity, certain physical features of the mouth, sleeping position or congestion.

Central sleep apnea or CSA is a less common form of sleep apnea which occurs when the brain fails to send proper signals to the muscles involved in breathing. This can be as a result of neurological conditions or associated with heart disorders.

Mixed sleep apnea is a combination of both OSA and the CSA where there is physical obstruction of the airway as well as neurological disruption of breathing signals. This is the most challenging of the three and can be difficult to diagnose and treat.

The symptoms of sleep apnea vary from patient to patient. Loud persistent snoring is a common symptom of OSA. With all three disorders patients experience tiredness and drowsiness throughout the day because of lack of quality sleep. Patients may also suffer from morning headaches, irritability, lowered productivity and even uncontrolled blood pressure and blood sugar levels. It is important that you speak to your doctor if you suffer from any of these symptoms or if you notice that you feel restless in your sleep, suffer from sudden awakenings or wake up with a dry or sore throat. 

If left untreated, sleep apnea can cause severe health risks. This includes high blood pressure, heart disease, type 2 diabetes, and metabolic syndrome. You may also be at greater risk of accident or injury because of increased tiredness and drowsiness. Other serious complications include an increased risk of stroke, atrial fibrillation, and liver disease. This is because of the reduced levels of oxygen and increased levels of carbon dioxide in the body throughout the night. 

Interlinking Sleep Apnea with Polycythemia

The biological link between sleep apnea and polycythemia can be attributed to the body's response to chronic intermittent hypoxia. The low oxygen level triggers the kidneys to release erythropoietin (EPO), a hormone that encourages the bone marrow to produce more red blood cells. This is to compensate for the lack of oxygen, leading to secondary polycythemia.

Clinical studies consistently support the link between OSA and polycythemia. Research shows that patients with severe OSA often have elevated hematocrit levels. However this can sometimes be as a result of inflammation and other metabolic changes associated with OSA, complicating the diagnosis.

A clinical trial investigating the effect of continuous positive airway pressure (CPAP) on RBC count, suggests that treating OSA with CPAP can reduce hematocrit levels. This shows that the effective management of OSA can alleviate polycythemia. Case studies show how patients with OSA treated with CPAP have normal hematocrit levels, emphasising the need for managing sleep apnea effectively. 

CPAP is the gold standard for managing sleep apnea. It works by passing a steady flow of pressurised air into your nose and mouth as you sleep, keeping your airways open and helping you breathe normally. This helps maintain good oxygen levels as well as removing carbon dioxide from the body effectively throughout the night. This reduces the need for increased red blood cell production maintaining a healthy hematocrit level. By monitoring hematocrit levels of patients using CPAP, doctors can further confirm the efficacy of CPAP therapy on polycythemia. 

As well as CPAP there are other methods of managing sleep apnea. This includes maintaining a healthy lifestyle. You should maintain a healthy diet and participate in regular exercise so that you are a healthy weight. If necessary it is important to lose weight as this can help reduce the symptoms of sleep apnea. Making better lifestyle choices for example if you smoke or drink excessively, you should quit smoking and reduce your alcohol intake as much as possible. This will improve your health and well-being as well as reduce your symptoms. In turn your body will not need to compensate for reduced oxygen levels in the body therefore alleviating polycythemia, which otherwise can potentially be life-threatening. 

Conclusion

In conclusion, it is very likely that sleep apnea can cause polycythemia. Studies show that low levels of oxygen in the body as a result of sleep apnea triggers increased production of red blood cells to compensate.

Continuous positive airway pressure (CPAP) therapy which is the gold standard for managing sleeper apnea may be effective in alleviating polycythemia, as demonstrated in several case studies.

By acknowledging the possible link between the two disorders, it will be easier for the doctor to provide you with an accurate diagnosis and effective treatment plan. Early diagnosis and treatment of both conditions is important for good health and well-being and for preventing more serious complications in the future. If you or your loved one is suffering from sleep apnea or possible polycythemia it is important that you speak to your doctor as soon as possible.