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

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 was calculated by correcting the time measured by the pulse oximeter for sleep duration computed by the actigraph. SDB severity was defined by actigraph-adjusted 3% oxygen saturation index 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 females, 1,580; postmenopausal females, 3,058; and males, 2,198). Multivariate analysis revealed that actigraph-adjusted 3% oxygen saturation index was negatively correlated with hemoglobin level in premenopausal females (β = -0.13, P < .01), but no significant correlations were found in postmenopausal females and males. In addition, the presence of SDB was a risk factor for microcytic anemia (hemoglobin < 12 g/dL and mean corpuscular volume < 80 fL) in premenopausal females (odds ratio and 95% confidence interval: mild SDB, 1.93 [1.31-2.84], P < .01; moderate to severe SDB, 9.02 [3.02-26.88], P < .01).

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

Citation: Murase K, Matsumoto T, Tabara Y, et al. Correlation of sleep-disordered breathing with anemia and microcytosis in premenopausal females: the Nagahama study. J Clin Sleep Med. 2025;21(7):1155-1164.