Chest
Determinants of Hypercapnia in Occlusive Sleep Apnea Syndrome
Section snippets
MATERIALS AND METHODS
One hundred and fifty-two consecutive adult patients undergoing nocturnal polysomnography at the University of Illinois Hospital were prospectively considered for entry into the study during a two-year period. This patient population is derived from the inpatients and outpatients of our institution, as well as referrals from community hospitals and clinics. From this population, patients with occlusive sleep apnea defined on the basis of a history of hypersomnolence and snoring, and an
RESULTS
There were 75 men and 36 women, of whom 22 and 19, respectively, were hypercapnic at the time of presentation. The chronicity of hypercapnia was evident by the mean value (± 1 SE) for arterial pH, which for hypercapnic individuals was 7.39±0.01.
The mean (±1 SE) and the range for age, weight-height ratio, arterial blood gas levels, and selected pulmonary function and sleep study variables for the hypercapnic and normocapnic patients are shown in Table 1. The patient population was predominantly
DISCUSSION
The results of this study suggest that the development of alveolar hypoventilation in patients with occlusive sleep apnea syndrome is indeed multifactorial. Conflicting results from previous studies regarding the importance of weight, muscle function, obstructive disease of the airways, and the severity of sleep-induced respiratory abnormalities1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 1, 16, 17, 18, 19 may have arisen from the small number of hypercapnic patients studied. In addition to
ACKNOWLEDGMENT
We thank Dr. Patricia Langenberg for her helpful suggestions regarding the statistical methods.
REFERENCES (38)
- et al.
Current concepts in the pathogenesis of the obesity-hypoventilation syndrome
Am J Med
(1974) - et al.
Respiratory defects in extreme obesity
Am J Med
(1962) - et al.
Therapeutic use of progesterone in alveolar hypoventilation associated with obesity
Am J Med
(1968) - et al.
Normal chemoreceptor function in obesity before and after weight reduction
Am J Med
(1975) - et al.
Decreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome
Am J Med
(1975) - et al.
Alveolar hypoventilation syndrome: studies of ventilatory control in patients selected for diaphragm pacing
Am J Med
(1978) - et al.
The cardiorespiratory effects of obesity
Clin Chest Med
(1980) - et al.
Hypercapnia in the obstructive sleep apnea syndrome: a reevaluation of the “pickwickian syndrome.”
Chest
(1986) - et al.
Relationship between pulmonary function and sleep-induced respiratory abnormalities
Chest
(1985) Gas exchange and hemodynamics during sleep
Clin North Am
(1985)
Extreme obesity associated with alveolar hypoventilation: a pickwickian syndrome
Am J Med
Compliance of the respiratory system in health and obesity
J Appl Physiol
Effects of mass loading the respiratory system in man
J Appl Physiol
Mass loading, sleep apnea and the pathogenesis of obesity hypoventilation
Am Rev Respir Dis
Respiratory control and work of breathing in obese subjects
J Appl Physiol
Diaphragm activity in obesity
J Clin Invest
The effects of weight reduction on pulmonary function and the sensitivity of the respiratory center in obesity
Am Rev Respir Dis
Progressive improvement of apnea index and ventilatory response to CO2 after tracheostomy in obstructive sleep apnea syndrome
Am Rev Respir Dis
Oxyhemoglobin saturation during sleep in patients with and without the obesity-hypoventilation syndrome
Chest
Cited by (75)
The burden of obesity hypoventilation syndrome
2020, Obesity Hypoventilation Syndrome: From Physiologic Principles to Clinical PracticeThe pathophysiology of obesity hypoventilation syndrome
2020, Obesity Hypoventilation Syndrome: From Physiologic Principles to Clinical PracticeObesity hypoventilation syndrome: Epidemiology and diagnosis
2014, Sleep Medicine ClinicsAcute hypercapnic respiratory failure in patients with sleep apneas
2010, Archivos de Bronconeumologia
Supported by the Medical Research Service of the Veterans Administration and the Chicago Lung Association.
Published in an abstract form in the American Review of Respiratory Diseases (1986; 133:A342).
Manuscript received October 2; revision accepted March 4