DOI: 10.4103/jasi.jasi_70_25 ISSN: 0003-2778

The Incidence of Hemoglobin Increase in OSAHS Patients and its Clinical Significance

Meihua Wang, Ningxia Wu, Kang Zhao
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Objective:

Understanding snoring syndrome – obstructive sleep apnea-hypopnea syndrome (OSAHS) potential impact on red blood cell count (RBC) and hemoglobin (HGB) levels needs more clarity for better patient care. This research aims to determine the prevalence of raised HGB among OSAHS individuals, study its influencing factors, and determine whether it helps predict conditions like Type 2 respiratory failure.

Methods:

OSAHS leads to an increase in HGB because it can cause compensatory erythropoiesis and blood concentration. Similarly, elevated HGB can also exacerbate breathing difficulties and increase the risk of cardiovascular diseases. We selected 632 OSAHS patients who were hospitalized in the Department of Otorhinolaryngology of the Affiliated Hospital of Yan‘an University in Shaanxi Province from 2022 to 2024 as the research sample. The data after screening based on various conditions were significantly representative. The data were balanced through propensity scores, and the patients with elevated HGB were divided into the HGB-elevated group ( n = 80). Patients without elevated HGB were matched based on factors such as age, gender, and body mass index (BMI) to form the normal HGB group ( n = 80). Then compare the polysomnography parameters and clinical manifestations of the two groups of patients; Check the indicators and the occurrence of complications. We also used Spearman’s rank correlation analysis and multiple linear regression analysis to explore the influencing factors of HGB. In addition, we used the receiver operating characteristic (ROC) curve to evaluate the possibility of HGB predicting the development of type II respiratory failure in patients with OSAHS.

Results:

This research revealed that 27.8% (176/632) of our OSAHS participants had high HGB levels, with males (32.2%) showing a notably higher prevalence than females (18.9%). The occurrence of a higher apnea hypopnea index (AHI) was associated with heightened HGB and breathlessness risks. The high HGB group demonstrated poorer performance across key physiological indicators like: Maximum airway pressure (maxAT), percentage of obstruction time (TS90%), RBC, HGB content, hematocrit, mean intracellular hemoglobin concentration (MCHC), aspartate aminotransferase, alanine aminotransferase, uric acid (UA), and partial pressure of carbon dioxide (PCO 2 and PaCO 2 ). Furthermore, their oxygen saturation (MSpO 2 ), peripheral blood oxygen saturation (LSpO 2 ), and oxygen partial pressure (PaO 2 ) were lower. They were also at risk from such conditions as hyperuricemia, proteinuria, and hypercapnia. Interestingly, increasing HGB seemed to correlate positively with BMI, AHI, maxAT, TS90%, PaCO 2 , UA, etc., but negatively with MSpO 2 , LSpO 2 , and PaO 2 . Multiple linear regression analysis indicated that age, BMI, maxAT, MSpO 2 , LSpO 2 , PaCO 2 , creatinine, and UA significantly influenced HBG. The HGB cut-off point for predicting type II respiratory failure in female OSAHS patients was 157.5 g/L, yielding a sensitivity of 82.0%, a specificity of 69.1%, and an area under the ROC curve (AUC) of 0.602 (95% confidence interval [CI] [0.603, 0.785], P = 0.012). For males, the threshold was 167.2 g/L, resulting in a sensitivity of 87.5%, a specificity of 78.1%, and an AUC of 0.763 (95% CI [0.842, 0.923], P = 0.002).

Conclusion:

Patients with OSAHS with elevated HGB are more complex and prone to complications. It is worth noting that the degree of HGB increase may also be an important reference standard for predicting the risk of type II respiratory failure in OSAHS patients. Patients with elevated HGB are more likely to develop malignant tumors of the blood system, which will further affect the physiology and psychology of patients and lead to a variety of diseases. Therefore, it is urgent to prevent and treat OSAHS.

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