Food and Behaviour Research

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Membrane level of omega-3 docosahexaenoic acid is associated with severity of obstructive sleep apnea.

Ladesich JB1, Pottala JV, Romaker A, Harris WS. (2011) J Clin Sleep Med.  7(4) 391-6. doi: 10.5664/JCSM.1198. 

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Patients with obstructive sleep apnea (OSA) are at increased risk of cardiovascular disease (CVD). The omega-3 fatty acid docosahexaenoic acid (DHA) is a major component of neural tissues, and supplementation with fish oils improves autonomic tone and reduces risk for CVD. A link between low DHA status and less mature sleep patterns was observed in newborns.


We investigated the relations between red blood cell (RBC) levels of DHA and OSA severity in 350 sequential patients undergoing sleep studies. Severity categories were defined as none/mild, moderate, and severe, based on apnea hypopnea index (AHI) scores of 0 to 14, 15 to 34, and > 34, respectively.


After controlling for age, sex, race, smoking, BMI, alcohol intake, fish intake, and omega-3 supplementation, RBC DHA was inversely related with OSA severity. For each 1-SD increase in DHA levels, a patient was about 50% less likely to be classified with severe OSA. The odds ratios (95% CI) were 0.47 (0.28 to 0.80) and 0.55 (0.31 to 0.99) for being in the severe group versus the none/mild or moderate groups, respectively.


These findings suggest that disordered membrane fatty acid patterns may play a causal role in OSA and that the assessment of RBC DHA levels might help in the diagnosis of OSA. The effects of DHA supplementation on OSA should be explored.

Omega-3 fatty acids, biomarkers, docosahexaenoic acid, epidemiology, sleep disordered breathing

Background and Rationale 

Low tissue levels of long-chain omega-3 fatty acids such as DHA may form part of the syndrome of sleep disordered breathing, inflammation, autonomic nervous system dysfunction and cardiovascular disease. This study was done to examine the extent to which omega-3 fatty acids in red blood cells were associated with the severity of obstructive sleep apnoea (OSA).

Summary and Conclusions

We found an inverse relationship between omega-3 DHA levels in red blood cells and the severity of OSA. This suggests that membrane fatty acid composition could make a contribution to the development of this disease. It therefore lays the groundwork for a clinical trial to determine if dietary supplementation with long-chain omega-3 could have benefits for patients with sleep disordered breathing.