Chest
ORIGINAL RESEARCHSLEEP MEDICINEObesity Hypoventilation Syndrome: Hypoxemia During Continuous Positive Airway Pressure
Section snippets
Subjects
A prospective study was undertaken of all subjects with extremely severe obesity (BMI ≥ 50 kg/m2) consecutively presenting to and undergoing diagnostic overnight polysomnography at the Royal Prince Alfred Hospital, Sydney, between August 2001 and January 2004. All subjects were referred to the unit for the investigation of possible sleep-disordered breathing. Any subject with a history or clinical examination suggestive of neuromuscular disease, chest wall disease (eg, kyphoscoliosis or polio),
Sleep Study Population and Recordings
Eighty subjects (34 men) with a BMI ≥ 50 kg/m2 presented to the sleep-disordered breathing clinic. All patients underwent polysomnography. Mild OSA (AHI, 5 to 14.9/h) was demonstrated in 10 subjects, moderate OSA (AHI, 15 to 29.9/h) was demonstrated in 14 subjects, and severe OSA (AHI > 30/h) was demonstrated in 50 subjects. All subjects had > 80% obstructive or mixed apneas and hypopneas. Six (7.5%) subjects did not demonstrate OSA (ie, an AHI < 5/h).
Exclusions
The 10 subjects with mild OSA were excluded
Discussion
The present study has shown that 1 night of CPAP therapy improves upper airway obstruction, arousal indexes, sleep architecture, and nocturnal oxygen desaturation in subjects with extremely severe obesity (BMI > 50 kg/m2) and moderate-to-severe OSA, with or without OHS. However, the response of nocturnal oxygen desaturation to CPAP was strikingly different in those with OSA and OHS, despite adequately treating the apneas and hypopneas, with 43% of these subjects continuing to desaturate with Spo
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The authors have no conflicts of interest to declare.