Treatment of Secondary Polycythemia in Obstructive Sleep Apnoea Syndrome
Erythrocytosis can arise as a consequence of obstructive sleep apnoea syndrome (OSA). Identifying and addressing the underlying cause is central to management in this specific clinical presentation.
Clinical scenario
This protocol applies to patients with secondary polycythemia in the setting of obstructive sleep apnoea syndrome, where erythrocytosis is associated with nocturnal oxygen desaturation. Such patients should be referred for appropriate investigation of the underlying sleep-disordered breathing.
Treatment approach (summary)
Management targets the underlying cause of nocturnal oxygen desaturation. A specific form of long-term non-invasive airway pressure therapy is central to this approach and has been shown to reduce erythrocytosis — but the full regimen and sequencing go beyond what is shown here.
Full protocol details, clinical targets, and decision points are available via the link below.
Clinical target
The primary goal of treatment is reduction of erythrocytosis, reflected by a fall in haematocrit.
References
DOI: 10.1111/bjh.15647
- Erythrocytosis can be associated with advanced chronic obstructive pulmonary disease (COPD) and with obstructive sleep apnoea syndrome (OSA).
- In the case of obstructive sleep apnoea, erythrocytosis is associated with nocturnal oxygen desaturation and such patients should be referred for appropriate investigation.
- Long term non-invasive continuous positive airway pressure (CPAP) has been shown to reduce erythrocytosis.
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