Those of you with OSA (Obstructive Sleep Apnea) may be unaware of one of the significant influences that OSA may have on your hemoglobin level.  Hemoglobin is the protein in our red blood cells that carries oxygen in our circulation to the rest of the body. It has been observed that patients with OSA often have an elevated red blood cell count and hemoglobin level.

An elevated hemoglobin level may seem like a good thing but increasing the number of red blood cells in our circulation may lead to other problems, including an increase in the “thickness” of our blood leading to clot formation. Increased clotting may lead to pulmonary emboli and heart attacks.

The relationship of the severity of OSA to increased hemoglobin has recently been studied, and an important correlation has been made. Initially, it was thought that the actual severity of the OSA was the cause, but researchers have found that it is really the drop in the patient’s oxygen level that is at the heart of the problem.  Patients with OSA all have some drop in their oxygen level when sleeping, but many have a severe reduction sometimes throughout the night.  It is this low oxygen level that causes the problem.

When the body senses frequent low oxygen levels it responds by increasing the amount of red cells with hemoglobin in our circulation.  This response also occurs in patients with persistently low oxygen levels from other causes, such as COPD or interstitial fibrosis.