Sleep and Biological Rhythms

, Volume 17, Issue 1, pp 141–148 | Cite as

Correlation of changes in the red blood cell distribution width with the response to continuous positive airway pressure in patients with obstructive sleep apnea

  • Huseyin Lakadamyali
  • Tulay Kivanc
  • Aynur Yilmaz AvciEmail author
Original Article


It is recently found that the red blood cell distribution width (RDW) is independently associated with cardiovascular disease in patients with obstructive sleep apnea (OSA).The goal of this study is to investigate the correlation of RDW with the severity of OSA and whether RDW could be used to monitor the response to continuous positive airway pressure (CPAP) therapy in OSA patients. The study enrolled 70 participants. Control group (n = 24) consisted of patients with normal polysomnography and OSA group (n = 46) comprised patients with OSA of varying severity. RDW was measured before polysomnography in both groups. In addition, RDW was measured in the OSA group following 3 months of CPAP therapy. The RDW was significantly higher in the OSA group (p < 0.001), and this difference remained after adjusting for age and body mass index (p = 0.001). The RDW was approximately twofold greater in the OSA group (OR 2.126, 95% confidence interval 1.32–3.41; p = 0.002). On univariate analysis, the RDW was significantly correlated with hypoxia parameters, which was persistent with multivariate analysis. Furthermore, CPAP therapy reduced RDW (p = 0.002), and the change in the severity of 3% ODI by CPAP was correlated with the change in the RDW (r = 0.416, p = 0.013). The high RDW may be related to the pathophysiology of OSA. The high RDW in OSA may be associated with hypoxia. Therefore, treating OSA with CPAP could improve the RDW.


Sleep-disordered breathing Respiratory disease Hypoxia Hematology Erythrocyte index 


Author contributions

HL and TK conceived and designed the study, acquired the data, and wrote the manuscript. AYA critically revised the manuscript and contributed important intellectual content.


No funding was received for this research.

Compliance with ethical standards

Conflict of interest

Lakadamyali H. declares that he has no conflict of interest. Kivanc T. declares that he has no conflict of interest. Yilmaz Avci A. declares that she has no conflict of interest.

Ethical approval

This study was approved by Ministry of Health Research and Training Center Clinical Research Ethical Committee approval number 2015-110 and conducted in accordance with Declaration of Helsinki 1964.

Informed consent

Informed consent was obtained from all participants included in the study.


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Copyright information

© Japanese Society of Sleep Research 2018

Authors and Affiliations

  • Huseyin Lakadamyali
    • 1
  • Tulay Kivanc
    • 2
  • Aynur Yilmaz Avci
    • 3
    Email author
  1. 1.Department of Pulmonary MedicineBaskent University Faculty of MedicineAnkaraTurkey
  2. 2.Department of Pulmonary MedicineMedova HospitalKonyaTurkey
  3. 3.Department of NeurologyBaskent University Faculty of Medicine, Baskent University HospitalAlanyaTurkey

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