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Volume 13 No. 10
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Accepted Papers

Scientific Investigations

Omega-3 Index and Obstructive Sleep Apnea: A Cross-Sectional Study

Janine Tittus, MD1; Marie Theres Huber1; Klaus Storck, MD2; Anton Köhler, MD1; Jan M. Köhler1; Thomas von Arnim, MD3; Clemens von Schacky, MD1,4
1Preventive Cardiology, University of Munich, Munich, Germany; 2Lungenärzte am Rotkreuzplatz Munich, Munich, Germany; 3Rotkreuzklinikum, Munich, Germany; 4Omegametrix, Martinsried, Germany

Study Objectives:

Erythrocyte levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Omega-3 Index) were previously found to be associated with obstructive sleep apnea (OSA) at very low levels (< 5.0%) in only one epidemiologic study. OSA has comorbidities, such as arterial hypertension, heart failure, or major depression, also associated with a low Omega-3 Index. These comorbidities can be improved by increasing intake of EPA and DHA, and thus the Omega-3 Index, preferably to its target range of 8% to 11%. Symptoms of OSA might improve by increasing the Omega-3 Index, but more research is needed.


In our sleep laboratory, 357 participants with OSA were recruited, and data from 315 participants were evaluated. Three categories of OSA (none/ mild, moderate, severe) were defined based on apnea-hypopnea index. Anthropometrics and lifestyle characteristics (smoking, alcohol, fish intake, omega-3 supplementation) were recorded. Erythrocyte fatty acid compositions were assessed with the HS-Omega-3 Index methodology.


The mean Omega-3 Index in all 3 categories of OSA was 5.7%, and no association with OSA was found. There were more male participants with severe OSA (79.7%, P = .042) than females, and participants with severe OSA had a significantly higher body mass index (32.11 ± 6.39 kg/m2, P = .009) than participants with mild or moderate OSA. Lifestyle characteristics were not significantly different.


In contrast to our hypothesis, an Omega-3 Index of 5.7% was not associated with OSA severity. Previously, an Omega-3 Index < 5.0% was associated. Although our results suggest aiming for an Omega-3 Index > 5.7% in an intervention trial with EPA and DHA in OSA, comorbidities of OSA suggest a target range of 8% to 11%.


Tittus J, Huber MT, Storck K, Köhler A, Köhler JM, von Arnim T, von Schacky C. Omega-3 Index and obstructive sleep apnea: a cross-sectional study. J Clin Sleep Med. 2017;13(10):1131–1136.

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