Correlation of sleep-disordered breathing with anemia and microcytosis in premenopausal women: the Nagahama study.

Abstract

Study objectives: While nocturnal hypoxia caused by sleep-disordered breathing (SDB) can result in polycythemia, the association between erythrocyte values and SDB may vary by sex and menopausal status. This study aimed to evaluate the correlation of erythrocyte variables with SDB in a large cohort categorized by sex and menopausal status from the general population.

Methods: Sleep duration and SDB were assessed in community residents using a wearable actigraph and pulse oximeter. The Actigraph-adjusted 3% oxygen saturation index (Acti-3% ODI) was calculated by correcting the time measured by the pulse oximeter for sleep duration computed by the actigraph. SDB severity was defined by Acti-3% ODI as normal (<5 events/h), mild (5 to <15 events/h), and moderate to severe (≥15 events/h).

Results: Data were obtained from 6,836 participants (premenopausal women, 1,580; postmenopausal women, 3,058; and men, 2,198). Multivariate analysis revealed that Acti-3%ODI was negatively correlated with hemoglobin (Hb) level in premenopausal women (β= -0.13, p < 0.01), but no significant correlations were found in postmenopausal women and men. In addition, the presence of SDB was a risk factor for microcytic anemia (Hb < 12 g/dl and Mean corpuscular volume < 80 fl) in premenopausal women (odds ratio and 95% confidence interval: mild SDB, 1.93 (1.31-2.84), p < 0.01; moderate to severe SDB, 9.02 (3.02-26.88), p < 0.01).

Conclusions: SDB was associated with microcytic anemia in premenopausal women. When SDB is diagnosed in a premenopausal woman, we may need to evaluate her erythrocytic parameters.