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- Impact of obstructive sleep apnea on hematocrit levels and erythrocytosis – a clinical studyPublication . Guerra, Patrícia; Alfaiate, Daniel; Pinto, Nuno; Pereira, Telmo; Pereira, AlexandreObjective - Assess differences between hematocrit levels in a population with and without obstructive sleep apnea (OSA) and determine if these differences correlate with disease severity and/or with levels of hypoxemia. Material and methods - Data was collected from patients who underwent level I polysomnography (PSG) in the sleep laboratory at Hospital Rainha Santa Isabel, Torres Novas, Portugal, between January 2018 and December 2022. The patients' medical data was analyzed and sociodemographic (gender, body mass index (BMI) and age), polysomnographic (Apnea and Hypopnea Index (AHI), mean SpO2, minimum SpO2, Oxygen Desaturation Index (ODI), T90 and T85) and laboratory data (hematocrit (HCT), hemoglobin (HGB) and erythrocyte count) were collected. Statistical analysis included one-way ANOVA with Tukey’s HSD for pairwise comparisons, Pearson’s correlation for associations between polysomnographic and hematological parameters, and multivariate regression to identify independent factors. Results - HCT levels were found to be higher in the moderate OSA group, particularly compared to the no OSA group (42.34 ± 4.09% vs 40.28 ± 2.75%), with significant differences between groups (p = 0.032). Although HCT levels were shown to be higher in the OSA group, the mean values remained within normal range, so no patient manifested erythrocytosis. Conclusion - Our results suggest that moderate OSA is associated with increased HCT levels but does not seem to cause secondary erythrocytosis. Future research should further evaluate the hypoxic burden of OSA, as increased HCT may raise the risk of cardiovascular complications.
- Class-specific and cumulative effects of psychotropic medication on sleep architecture: a polysomnographic retrospective studyPublication . Alfaiate, Daniel; Silva, Patrícia; Guerra, Patrícia; Pinto, Nuno; Pereira, AlexandreObjective: This study aims to investigate the impact of psychotropic medication interactions on sleep architecture. With the growing use of psychotropics, including antidepressants, antipsychotics, and mood stabilizers, this research seeks to understand how these drugs and their cumulative burden may affect key sleep parameters. Material and methods: This retrospective study analyzed 60 non-psychotropic medication users, as well as 61 psychotropic medication users who underwent hospital polysomnography and met all inclusion criteria. Sociodemographic and polysomnographic data were obtained from a sleep laboratory database, between January 2018 and December 2021. Statistical analysis included normality assessment and appropriate parametric or nonparametric tests for group comparisons. Multivariable general linear models adjusted for age, sex, and BMI with HC3 robust errors evaluated associations. Cumulative psychotropic burden was analyzed as a continuous predictor. Results: Medicated individuals exhibited reduced sleep efficiency (p = .001), prolonged sleep onset and REM latency (p = .001), increased light sleep, and fewer sleep cycles. Multivariable analyses showed antidepressants markedly increased REM latency (p = .001) and periodic limb movements (p = .015), while anticonvulsants enhanced slow-wave sleep (p = .013) and antipsychotics reduced arousals (p = .004). A dose–response relationship was observed, with greater psychotropic burden independently associated with longer REM latency (p = .029) and reduced arousal index (p = .001). Conclusion: Psychotropic medications alter sleep architecture in recognizably class-specific ways, and these effects compound as the number of concurrent agents grows. Clinically, this argues for treating total psychotropic burden as a relevant variable in the interpretation of polysomnography, and underscores the need for prospective studies that account for dosage, serum levels, and cognitive outcomes.