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

Year 2024, Volume: 9 Issue: 2, 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

Aim
This study aims to assess the prevalence of overlap syndrome (OS) in Chronic Obstructive Pulmonary Disease (COPD) patients with Obstructive Sleep Apnea(OSA) symptoms undergoing polysomnography. We investigated the impact of hypoventilation and long-term oxygen therapy (LTOT) on the severity of OSA.
Material and Methods
We retrospectively reviewed COPD patients with OSA symptoms who underwent polysomnography from August 2012 to September 2022. The individuals' body mass index (BMI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), minimum and mean oxygen saturation values (minSpO2 and meanSpO2), sleep activities, REM period percentages (REM%), whether they used LTOT, and blood hematocrit levels and awake arterial carbon dioxide (PaCO2) levels were recorded.
Results
A total of 81 individuals with COPD were included in the study. The number of individuals with AHI>5 was 76(93.9%). Participants included 9 with mild OSA, 24 with moderate OSA and 43 with severe OSA. The mean sleep efficiency was found to be %78.3. The mean value of REM% was 7.3. Sixteen of the patients (19.7%) were receiving LTOT. Sleep efficiency was statistically higher in the group using LTOT (p=0.048). AHI and ODI values were statistically higher in the group with high PaCO2 than in the group without (respectively; p=0.048, p=0.008). The mean values of min SpO2 and meanSpO2 were found to be lower in the group with high PaCO2 (p=0.013, p=0.008; respectively)
Conclusion
In OS participants, sleep efficiency is low, and having high PaCO2 is associated with lower minSpO2 and meanSpO2, higher ODI, and AHI. The use of LTOT increases sleep efficiency.

Keywords

obesity, hypoventilation, polysomnography, apnea

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

Abstract

Amaç
Bu çalışmanın amacı, Kronik obstrüktif akciğer hastalığı (KOAH) olup obstrüktif uyku apnesi (OUA) belirtileri nedeniyle polisomnografi yapılanlarda, overlap sendromu (OS) prevalansını belirlemektir. Ayrıca, hipoventilasyon ve uzun süreli oksijen tedavisinin (LTOT) OSA şiddetine etkisini inceledik.
Araç ve Yöntem
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 periyodu 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. AHİ>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 değeri 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 (sırasıyla; p=0,048, p=0,008). Ayrıca ortalama min SpO2 ve mean SpO2 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 meanSpO2, daha yüksek ODI ve AHI ile ilişkilidir. USOT kullanımı OS'li hastalarda uyku etkinliğini artırmaktadır.

Keywords

obezite, hipoventilasyon, polisomnografi, apne

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