Obstrüktif Uyku Apnesi ile Kronik Obstrüktif Akciğer Hastalığı Arasındaki Uzun Dönem İlişkinin Analizi: 10 Yıllık Retrospektif Bir Çalışma

Year 2024, , 52 - 56, 16.08.2024

Nur Aleyna Yetkin , Burcu Baran Ketencioğlu , Mohammed Almadqa , Fatma Sema Oymak , İnci Gülmez , Nuri Tutar

https://doi.org/10.55694/jamer.1457857

Abstract

Amaç: Bu çalışmanın amacı, Kronik obstrüktif akciğer hastalığı (KOAH) olup obstrüktif uyku apnesi (OUA) belirtileri nede-
niyle polisomnografi yapılanlarda, overlap sendromu (OS) prevalansını belirlemektir. Ayrıca, hipoventilasyon ve uzun süreli
oksijen tedavisinin (USOT) OUA şiddetine etkisini inceledik.
Gereç ve Yöntemler: Ağustos 2012’den Eylül 2022’ye kadar OUA semptomları olup polisomnografi yapılan KOAH hastalarını
retrospektif olarak inceledik. Hastaların vücut kitle indeksleri (VKİ), apne-hipopne indeksleri (AHİ), oksijen desatürasyon
indeksleri (ODI), minimum ve ortalama oksijen satürasyon değerleri (minSpO2 ve ortalamaSpO2), uyku aktiviteleri, REM pe -
riyodu yüzdeleri (%REM), USOT kullanıp kullanmadıkları, kan hematokrit düzeyleri ve uyanık arteriyel karbondioksit parsiyel
basıncı (PaCO2) seviyeleri kaydedildi.
Bulgular: Çalışmaya toplam 81 KOAH’lı birey dahil edildi. AHI>5 ve OS olan birey sayısı 76 (%93,9) idi. Çalışmaya dahil
edilenlerin 9’u hafif, 24’ü orta ve 43’ü şiddetli OSA olarak bulundu. Ortalama uyku etkinliği 78,3 (±16,2) ve %REM değe-
ri 7.3 idi. Hastaların 16’sı (%19.7) USOT alıyordu. Uyku etkinliği USOT kullanan grupta istatistiksel olarak daha yüksekti
(p=0,048). PaCO2’si yüksek olan grupta AHI ve ODI değerleri olmayan gruba göre istatistiksel olarak yüksek bulundu (sıra-
sıyla; p=0,048, p=0,008). Ayrıca minSpO2 ve meanSpO2 değerleri PaCO2’si yüksek olan grupta daha düşük bulundu (sırasıyla
p=0,013, p=0,008).
Sonuç: KOAH-OSA overlap hastalarda uyku etkinliği düşüktür ve noktürnal hipoventilasyon daha düşük minSpO2 ve me-
anSpO2, daha yüksek ODI ve AHI ile ilişkilidir. USOT kullanımı OS’li hastalarda uyku etkinliğini artırmaktadır.

Keywords

apne, hipoventilasyon, obezite, polisomnografi

Analysis of the Long-Term Correlation Between Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease: A 10-Year Retrospective Study

Abstract

Aim: The primary objective of this study is to evaluate the prevalence of overlap syndrome (OS) in patients with Chronic Obst-
ructive Pulmonary Disease (COPD) who exhibit symptoms of Obstructive Sleep Apnea (OSA) and are undergoing polysomnog-
raphy. The study also aims to explore the influence of hypoventilation and long-term oxygen therapy (LTOT) on the severity of
OSA.
Materials and Methods: A retrospective analysis was conducted on COPD patients presenting symptoms of OSA who underwent
polysomnography between August 2012 and September 2022. Data on the patients’ body mass index (BMI), apnea-hypopnea
index (AHI), oxygen desaturation index (ODI), minimum and mean oxygen saturation levels (minSpO2 and meanSpO2), sleep
efficiency, percentage of REM period (REM%), LTOT usage, hematocrit levels, and awake arterial carbon dioxide (PaCO2)
levels were collected.
Results: The study involved 81 COPD patients. Among them, 76 individuals (93.9%) had an AHI>5, with 9 classified as having
mild OSA, 24 as moderate OSA, and 43 as severe OSA. The average sleep efficiency was 78.3%, and the mean REM% value was
7.3. Sixteen patients (19.7%) were using LTOT, and a statistically significant higher sleep efficiency was observed in this group
(p=0.048). Patients with elevated PaCO2 levels exhibited significantly higher AHI and ODI values compared to those with nor-
mal PaCO2 levels (p=0.048, p=0.008, respectively). Additionally, the mean minSpO2 and meanSpO2 values were lower in the
high PaCO2 group (p=0.013, p=0.008, respectively).
Conclusion: In individuals with OS, reduced sleep efficiency is noted, and elevated PaCO2 levels are associated with decreased
minSpO2 and meanSpO2 levels, higher ODI and AHI values. The utilization of LTOT is linked to improved sleep efficiency.

Keywords

apnea, hypoventilation, obesity, polysomnography

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