Decrease in haematocrit with continuous positive airway pressure treatment in obstructive sleep apnoea patients.

Abstract

Previous preliminary results have shown an overnight decrease in haematocrit and red cell count after the first night of treatment with nasal continuous positive airway pressure (CPAP) in obstructive sleep apnoea (OSA) patients. The present study was designed to confirm these preliminary data, and to analyse the long-term effects of CPAP. The haematocrit and red cell count (RCC) were measured in 80 OSA patients on two consecutive mornings, after an untreated night and after a CPAP treatment night. The haematocrit and RCC significantly decreased with CPAP (from 44.0 +/- 0.5 to 42.4 +/- 0.4%, p less than 0.0001 and from 4.769 +/- 0.051 to 4.597 +/- 0.052 x 10(12) red cells.l-1, p less than 0.0001, respectively). Neither the decrease in haematocrit nor the decrease in RCC were correlated with the decrease in urine volume or flow which occurred with CPAP. Thirty five of these patients remained untreated for 45 +/- 4 days, before home treatment with CPAP was initiated. The haematocrit and RCC had returned to values close to those before initial treatment and decreased again after the first treatment night. Twenty one of the patients were re-evaluated after at least one year of home treatment with CPAP, again on two consecutive nights either with CPAP or untreated. The follow-up, post-CPAP haematocrit and RCC were slightly and nonsignificantly higher than after the baseline CPAP night, but still lower than after the baseline untreated night (p less than 0.02). After the untreated follow-up night, no significant change in haematocrit was observed.(ABSTRACT TRUNCATED AT 250 WORDS)