SEVERE obstructive sleep apnea (OSA) is independently associated with elevated C-reactive protein (CRP) levels, a key marker of systemic inflammation and cardiovascular risk, according to new research analyzing over 2,400 patients. This large-scale study also uncovers that obesity, chronic obstructive pulmonary disease (COPD), and comorbid insomnia (COMISA) further elevate CRP in individuals with OSA—insights that may reshape how healthcare professionals approach cardiovascular risk management in these patients.
In this investigation, 2,404 adults with suspected OSA underwent standard respiratory polygraphy at a university hospital. Blood samples were analyzed for CRP, stratified into three groups: low (<1 mg/L), moderate (1-3 mg/L), and high (>3 mg/L). Severe OSA, defined as ≥30 respiratory events per hour, emerged as an independent predictor of high CRP levels, with an adjusted odds ratio (OR) of 1.70 (95% CI 1.18-2.44). This association held even after adjusting for oxygen saturation, sex, age, and body mass index (BMI).
Interestingly, sleep duration, whether short (<6 hours) or long (≥9 hours), did not significantly influence CRP levels in this population, challenging assumptions about sleep length and systemic inflammation. However, comorbid conditions played a substantial role. Obesity was the strongest predictor of elevated CRP (adjusted OR=3.64, 95% CI 2.06-6.41), followed by COPD (adjusted OR=2.53, 95% CI 1.34-4.75) and COMISA (adjusted OR=1.44, 95% CI 1.07-1.95). These findings underscore the importance of comprehensive patient assessment beyond sleep apnea severity alone. For clinicians, addressing comorbid obesity, COPD, and insomnia in patients with OSA could be crucial for mitigating inflammation-related cardiovascular risks. This evidence supports integrating broader comorbidity management into standard OSA care to improve long-term outcomes. Reference: Furuholmen L et al. Severity of obstructive sleep apnea is related to C-reactive protein levels: The influence of comorbidities and self-reported sleep duration. Sleep Med. 2025;114:43-50.
