Comment on: use of blood biomarkers to screen for obstructive sleep apnea

Burton Abrams Zeger-Abrams Inc., Elkins Park, PA, USAThe recently published paper in Nature and Science of Sleep1 describes a combination of blood biomarkers for obstructive sleep apnea (OSA) screening which is shown to have better sensitivity and selectivity than any one individually. The combination comprises elevated levels of glycated hemoglobin (HbA1c), C-reactive protein, and erythropoeitin. The combination algorithm alluded to in the paper requires a sufficiently elevated level above a threshold of the combination of the three constituents for further diagnostic testing to be recommended. Of course, OSA would have to have been present long enough for the elevated levels to occur in order for the proposed biomarker to indicate its likely presence. My comment on this paper questions not whether this screening tool is valid, but whether it is valid early enough in the development of OSA to initiate diagnosis and treatment before some irreversible life-threatening consequence of OSA develops.View original paper by Fleming and colleagues