PURPOSE: Patients with Obstructive Sleep Apnea are at increased risk of cardiovascular disease. Previous research has shown that patients with cardiovascular disease benefit from supplementation of Omega-3 fatty acid containing compounds. We investigated whether or not Omega-3 levels were related to Apnea Hypopnea Index (AHI) scores. Previous work has shown red blood cell membrane Omega-3 levels to be equal to tissue cell membrane levels allowing us to use readily available blood cells for study.
METHODS: Sleep studies at our institution normally include arterial blood gas analysis. After informed consent, excess blood normally discarded after testing was analyzed for fatty acid levels. 350 sequential subjects who consented to the study with AHI's of 0 to 104 were included over an eighteen month period. ANOVA was also using Kruskal-Wallis nonparametric tests for continuous and ordinal variables and Chi-square test for categorical variables.
RESULTS: Docosahexaenoic acid (DHA) was found to inversely correlate after controlling for age, sex, race, smoking, BMI, fish intake, Omega-3 supplementation, flaxseed oil supplementation, and other fatty acids normally present in cellular membranes. AHI levels were grouped, 0 to 14, 15 to 34, and above 35. As a percentage of total fatty acid in the RBC membrane DHA percentages of total fatty acids were: 4.1% (3.4, 5.3), 4.5% (3.3, 5.8), 3.6% (2.9, 4.7) P-Value 0.03.
CONCLUSION: Increasing apnea severity is associated with lower DHA levels, after controlling for multiple variables that would normally alter DHA levels. Specifically, there appears to be a definite demarcation at AHI of 35.
CLINICAL IMPLICATIONS: An inverse association exists between DHA cellular membrane composition and AHI levels. Whether the increasingly severe apnea induces systemic changes that lower DHA levels or whether lower DHA levels might lead to worsening apnea is unclear. Future studies are needed to clarify if this association is clinically significant.
DISCLOSURE: James Ladesich, No Financial Disclosure Information; No Product/Research Disclosure Information