Chest
Clinical InvestigationsNocturnal Oxyhemoglobin Desaturation in COPD Patients with Arterial Oxygen Tensions Above 60 mm Hg
Section snippets
MATERIALS AND METHODS
We studied 152 male United States veterans from a medical chest clinic with the diagnosis of COPD using nocturnal polysomnography to detect oxyhemoglobin desaturation. Requirements for inclusion were as follow: (1) a clinical diagnosis of COPD characterized by symptoms of chronic cough, exertional dyspnea, or wheezing; (2) spirometry consistent with irreversible expiratory airflow obstruction (FEV1<80 percent predicted, FEV1/FVC<0.75) or evidence of airtrapping on body plethysmography; and (3)
RESULTS
Eight subjects were disqualified because of inability to achieve or maintain adequate sleep (more than one to two hours of NREM sleep) for sleep stage and SaO2 analysis. Most of these were studied on two or more occasions. Nine were disqualified because of the presence of five or more obstructive apneas per hour in spite of the absence of clinical symptoms of sleep apnea. Thirty seven (27 percent) of the remaining 135 subjects showed nocturnal oxyhemoglobin desaturation as described above (Fig 1
DISCUSSION
Transient oxygen desaturation in chronic lung disease probably results from a combination of alveolar hypoventilation and gas exchange abnormalities contributed to by REM sleep muscular atonia and changes in respiratory control.20, 21, 22 Attention has been given to the role of transient alveolar hypoxia and hypoxic vasoconstriction as possible causes of sustained pulmonary hypertension.13, 14 Several authors23, 24, 25, 26 have demonstrated that repetitive episodes of transient hypoxia in
REFERENCES (31)
- et al.
Arterial blood gases and pH during sleep in chronic obstructive pulmonary disease
Am J Med
(1975) - et al.
Disordered breathing and oxygen desaturation during sleep in patients with chronic obstructive lung disease (COLD)
Am J Med
(1979) - et al.
Transient hypoxemia during sleep in chronic bronchitis and emphysema
Lancet
(1979) - et al.
Nocturnal pulmonary hypertension in patients with chronic obstructive pulmonary disease
Chest
(1979) - et al.
Cardiopulmonary hemodynamics during sleep in subjects with chronic obstructive pulmonary disease: the effect of short and long term oxygen
Chest
(1984) Clinical hypoxia: causes, consequences, and correction
Lancet
(1978)- et al.
The origins of cor pulmonale, a hypothesis
Chest
(1979) - et al.
The effect of low flow oxygen on sleep disordered breathing and oxygen desaturation
Chest
(1980) - et al.
Oxygen desaturation during sleep as a determinant of the blue and bloated syndrome
Chest
(1981) - et al.
Oximeter studies on patients with chronic obstructive emphysema, awake and during sleep
N Engl) Med
(1962)
Hemoglobin desaturation: its occurrence during sleep in patients with cystic fibrosis
Am J Dis Child
Sleep hypoxemia in young adults with cystic fibrosis
Dis Child
Studies of oxygenation during sleep in patients with interstitial lung disease
Am Rev Respir Dis
Breathing during sleep in patients with interstitial lung disease
Am Rev Respir Dis
Sleep breathing abnormalities in kyphoscoliosis
Am Rev Respir Dis
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This study was supported by the General Research Service of the Veterans Administration. Computational assistance was provided by the CLINFO project, funded by the Division of Research Resources of the NIH under grant RR-00350.
Manuscript received December 29; revision accepted February 12.
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