Can Sleep Apnea Cause High White Blood Cell Count?

Last updated: January 28th, 2024

Can sleep apnea cause high white blood cell count? This question has been asked by many, and current research suggests a compelling link between this common sleep disorder and your body’s immune response. This article cuts through the medical jargon to present you with a clear, direct examination of how sleep apnea may influence white blood cell levels, grounding our discussion in scientific evidence.

Key Takeaways

  • Obstructive Sleep Apnea Syndrome (OSAS) is linked with systemic inflammation, contributing to cardiovascular diseases such as hypertension, stroke, and heart failure due to repeated airway obstruction during sleep.

  • Research suggests a correlation between OSA severity and increased neutrophil counts, indicating a potential contribution to leukocytosis and a heightened risk for autoimmune and cardiovascular diseases.

  • Continuous Positive Airway Pressure (CPAP) therapy has been effective in managing OSA and reducing inflammation and white blood cell counts, which may help lower cardiovascular risk and improve health outcomes.

Understanding Sleep Apnea and Its Effects on the Body

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder that can have profound effects on the body. It occurs when there are repeated episodes of partial or complete upper airway obstruction during sleep, disrupting normal breathing patterns, and leading to various health complications. A higher Apnea-Hypopnea Index (AHI), indicating severe obstructive sleep apnea, is linked to poorer endothelial function and an elevated risk of cardiovascular complications.

Thus, the severity of OSA might provide clues about the potential risk for inflammation and cardiovascular health problems.

Defining Obstructive Sleep Apnea

Patients with obstructive sleep apnea (OSA) experience a sleep disorder characterized by:

  • Recurrent episodes of partial or full obstruction of the upper airway during sleep

  • Interrupted breathing

  • Adverse effects on the individual’s health and well-being

Diagnosing OSA involves polysomnography - a comprehensive recording of biophysiological changes during sleep, which is an essential aspect of sleep medicine.

The severity of OSA is evaluated using the apnea hypopnea index (AHI), which encompasses all apneas, regardless of desaturation, and hypopneas accompanied by at least a 4% drop in oxygen saturation. A complex interplay of structural and nonstructural factors, including genetic predisposition, contributes to the pathophysiology of OSA. These factors involve anatomical susceptibilities of the upper airway and sleep-related changes that impact airway patency.

Systemic Inflammation in OSA

Obstructive Sleep Apnoea Syndrome (OSAS) goes beyond being merely a sleep disorder, as it also correlates with systemic inflammation, which may contribute to the development of cardiovascular diseases. The potential influence of OSA on systemic inflammation is significant, contributing to conditions that create a favorable environment for cardiovascular diseases.

For those suffering from obstructive sleep apnea, heightened systemic inflammation is associated with a range of health complications. This inflammation is a recognized contributor to the onset of several cardiovascular diseases, such as:

  • hypertension

  • stroke

  • heart failure

  • coronary artery disease

This links the two health conditions.

White Blood Cells: The Immune System's First Responders

Illustration of white blood cells in a blood sample

Having covered the basics of OSA, let’s now turn our attention to white blood cells, or leukocytes. These cells are the immune system’s first responders and play a crucial role in protecting the body from infections and diseases. Leukocytes generally have a normal count ranging between 4,000 and 11,000/microliters in a healthy individual. Any deviation from this range can be an indication of a health issue.

Types of White Blood Cells

There are five distinct types of white blood cells, each playing a unique part in the body’s immune response. They include:

  1. Neutrophils: function to protect the body from infections

  2. Monocytes: tasked with engulfing and digesting pathogens

  3. Eosinophils: contribute to allergic reactions and combatting parasites

  4. Basophils: release chemicals to regulate immune responses

  5. Lymphocytes: integral to the immune response

The different types of white blood cells are further differentiated into granulocytes, which include neutrophils, eosinophils, and basophils, and non-granulocytes, such as lymphocytes and monocytes. Each of these cells plays a crucial role in maintaining the body’s immune defense system and protecting us from disease.

Significance of Elevated White Blood Cell Count

Despite the critical role of white blood cells in our immune system, a high white blood cell count can signal the presence of several health concerns. It could be indicative of:

  • an ongoing infection

  • inflammation

  • other medical conditions such as asthma, burns, Churg-Strauss syndrome, hay fever, leukemia, lymphoma, myelofibrosis, polycythemia vera, pregnancy, and rheumatoid arthritis, among others.

An elevated white blood cell count is usually diagnosed through a complete blood count (CBC) test, which assesses the different types of cells present in the blood, including white blood cells. An elevated count is indicative of the body’s reaction to an infection or inflammation, as white blood cells are essential in the immune system’s defense against pathogens and in the inflammatory process.

Investigating the Connection: Sleep Apnea and Leukocytosis

Photo of a research study on sleep apnea and leukocytosis

Equipped with a clear understanding of white blood cells and OSA, let’s explore research examining the link between sleep apnea and leukocytosis. Leukocytosis is defined as an elevation in the quantity of white blood cells in the body. Interestingly, research has indicated a correlation between OSA and heightened levels of neutrophils, suggesting a relationship between OSA and leukocytosis.

Research Highlights

Studies have shown associations between OSA severity and increased neutrophil counts. This is significant because neutrophils are a type of white blood cell that plays a major role in the body’s defense against infections. An increase in their count can be indicative of systemic inflammation, a condition that contributes to the onset of various diseases, including:

  • cardiovascular diseases

  • respiratory diseases

  • metabolic disorders

  • autoimmune diseases

The neutrophil to lymphocyte ratio (NLR) is another parameter that has been found to correlate with the severity of OSA. This ratio provides insights into the body’s immune response and potential health issues. An elevated NLR value suggests an imbalance in the immune response, indicating a potentially higher risk for diseases.

Analyzing the Data

From the analysis of these study data, it appears that OSA might contribute to leukocytosis, thereby increasing the potential risk of cardiovascular diseases. One way it does this is by triggering an excessive production of white blood cells, leading to an elevation that may pose a heightened risk for health complications.

Further analysis of the research data indicates that OSA may be associated with an imbalanced immune response, as evidenced by a higher neutrophil-lymphocyte ratio (NLR) value in OSA patients compared to control subjects. This suggests that OSA may not only cause disruptions in sleep but could also potentially lead to significant impacts on the immune system and overall health.

The Role of CPAP Therapy in Managing OSA and Inflammation

Illustration of a CPAP machine used in therapy for obstructive sleep apnea

Continuous Positive Airway Pressure (CPAP) therapy has shown promising results in managing OSA and the inflammation associated with it. CPAP therapy alleviates airway obstruction and hypoxia, while also reducing airway and systemic inflammation and the levels of inflammatory mediators induced by OSA.

How CPAP Works

CPAP therapy utilizes a device that delivers a continuous airflow through a mask, which aids in keeping the airway open during sleep. This therapy enhances the quality of sleep in patients with OSA by mitigating excessive daytime sleepiness, enhancing the quality of life, and reinstating normal sleep patterns.

There are various types of CPAP machines currently in circulation, including:

  • Continuous PAP (CPAP)

  • Auto-adjusting PAP (APAP)

  • Bilevel PAP (BiPAP)

  • Travel CPAP machines

The ideal CPAP level is determined as the minimum pressure at which the fewest respiratory events and arousals occur while maintaining the highest sleep efficiency. This determination takes place in a laboratory setting under the supervision of a technician.

CPAP's Effect on Inflammatory Markers

CPAP therapy can significantly reduce white blood cell count and other inflammatory markers in OSA patients. Studies have demonstrated that CPAP therapy can result in noteworthy decreases in white blood cell count and other inflammatory markers in patients with OSA.

Apart from white blood cell count, CPAP therapy in OSA patients also has the potential to impact inflammatory markers such as C-reactive protein (CRP), cytokines, and TNF-α. After a period of 3 months, CPAP treatment has been observed to improve flow-mediated dilation (FMD), increase the number of endothelial progenitor cells (EPCs), and elevate the level of nitric oxide metabolites (NOx) in patients with OSA.

Beyond OSA: Other Factors Influencing White Blood Cell Count

Photo of lifestyle factors influencing white blood cell count

Although OSA significantly influences white blood cell count and inflammation, it isn’t the only contributing factor. Several other factors can impact white blood cell count, such as:

  • lifestyle and comorbid conditions

  • smoking

  • poor sleep

  • shift work

  • obesity

  • acute emotional or physical stress

  • dietary factors like copper and iron intake

Lifestyle and Stress

Lifestyle elements such as smoking, inadequate sleep, shift work, and obesity can lead to a heightened white blood cell count. In particular, chronic stress can induce an excessive production of white blood cells, leading to an elevation that may pose a heightened risk for health complications. It’s noteworthy that stress can influence the immune system, potentially causing fluctuations in white blood cell counts.

Apart from these, engaging in regular exercise has been shown to enhance the immune system and increase white blood cell count. A balanced diet and moderate alcohol consumption can also contribute to maintaining healthy white blood cell counts.

Comorbid Conditions

Coexisting conditions that can result in an increased white blood cell count include:

  • Cardiovascular disease

  • Chronic inflammation

  • Elevated depressive symptoms

  • Type 2 inflammation

In particular, conditions like obesity, often indicated by a high body mass index, and diabetes can result in an increased white blood cell count and induce increased inflammation, resulting in insulin resistance and heightened blood sugar levels.

Moreover, OSA itself has been linked with various types of cardiovascular disease, such as hypertension, stroke, heart failure, and coronary artery disease. Additionally, it has been associated with elevated rates of high blood pressure and a heightened risk of heart failure and coronary heart disease.

Implications for Clinical Practice and Future Research

The established links between OSA, inflammation, and cardiovascular risk clearly indicate significant implications for both clinical practice and further research. Recognizing OSA as a potential risk factor for other conditions, such as cardiovascular disease and asthma, and addressing inflammation in OSA patients is crucial.

Addressing Cardiovascular Risk Factors

Identification and management of OSA could aid in reducing inflammation and enhancing cardiovascular outcomes for patients. With OSA being linked to various types of cardiovascular disease, such as:

  • hypertension

  • stroke

  • heart failure

  • coronary artery disease

Effectively managing OSA can lead to improvements in these outcomes.

The benefits of reducing inflammation for individuals with cardiovascular disease are also noteworthy. It can provide benefits such as reducing the risk of cardiovascular disease, protecting the heart, and lowering the risk of heart disease, stroke, Alzheimer’s disease, and diabetes. Consumption of anti-inflammatory foods, such as green leafy vegetables, berries, nuts, and foods with higher levels of antioxidants and fiber, can aid in combating inflammation.

Prospects for Future Cardiovascular Events

Additional research is required for a better understanding of the relationship between OSA, inflammation, and cardiovascular risk, and the development of more effective therapeutic strategies. Untreated Obstructive Sleep Apnea patients may face potential future cardiovascular risks such as:

  • Hypertension

  • Stroke

  • Heart failure

  • Coronary artery disease

  • Increased risk of fatal cardiovascular events

There is a need to comprehend the pathophysiological mechanisms through which OSA contributes to cardiovascular illness. Studies involving the use of nasal continuous positive airway pressure (CPAP) as a treatment have shown enhancements in cardiovascular results.

Furthermore, there may be a focus on addressing lipid abnormalities and inflammatory markers to more effectively manage inflammation and cardiovascular risk.


In conclusion, the relationship between Obstructive Sleep Apnea, inflammation, and white blood cell count has far-reaching implications for our understanding of health and disease. As we have seen, OSA is not merely a sleep disorder but can significantly contribute to systemic inflammation and impact the body’s immune responses. Its link to elevated white blood cell count, or leukocytosis, provides an intriguing insight into the systemic effects of this common sleep disorder.

The importance of understanding and addressing this connection cannot be overstated. Be it through lifestyle changes, effective management of OSA through therapies like CPAP, or addressing comorbid conditions, tackling this connection head-on can have significant impacts on health outcomes. As we continue to unravel the complexities of this relationship, the hope is that this knowledge will lead to more effective strategies for managing OSA and improving the overall quality of life for those affected by this condition.

Frequently Asked Questions

Does sleep apnea affect white blood cell count?

Yes, sleep apnea can affect white blood cell count by causing heightened inflammation and innate immunity, potentially increasing cardiovascular risk.

Can lack of sleep affect your white blood cell count?

Yes, lack of sleep can affect your white blood cell count by causing a rise in white blood cell activity and count, particularly the type of white blood cell called granulocytes. This can impact the immune system's functioning.

Can sleep apnea cause high red blood cell count?

Yes, obstructive sleep apnea can cause an increase in red blood cell volume and hemoglobin concentration due to chronic intermittent hypoxia. This is the body's way of trying to improve oxygen delivery to tissues.

What is Obstructive Sleep Apnea (OSA)?

Obstructive sleep apnea (OSA) is a sleep disorder characterized by recurrent episodes of partial or full obstruction of the upper airway during sleep, leading to interrupted breathing and negative impacts on health and well-being.

What is the relationship between OSA and systemic inflammation?

OSA is associated with elevated systemic inflammation, which may contribute to the development of cardiovascular diseases.


No Comments

Post Comment

Prove you are human 10 + 6 =

Tagged: Sleep Apnea

Subscribe To Our Newsletter!