Abstract
BACKGROUND--Nocturnal desaturations, mainly caused by hypoventilation, occur frequently in patients with chronic obstructive pulmonary disease (COPD). Daytime arterial oxygen and carbon dioxide tensions (PaO2 and PaCO2) appear to predict which patients will desaturate at night. It is unknown if respiratory muscle strength, which may be decreased in these patients, plays an additional part. METHODS--Polysomnography, maximal respiratory pressures, lung function, and arterial blood gas tensions were measured in 34 patients with COPD (mean (SD) forced expiratory volume in one second (FEV1) 41.7 (19.9)% pred). RESULTS--Significant correlations were found between the mean nocturnal arterial oxygen saturation and maximal inspiratory mouth pressure (r = 0.65), maximal inspiratory transdiaphragmatic pressure (r = 0.53), FEV1 (r = 0.61), transfer coefficient (KCO) (r = 0.38), arterial oxygen saturation (SaO2) (r = 0.75), and PaCO2 (r = -0.44). Multiple regression analysis showed that 75% of the variance in nocturnal SaO2 (70%) and FEV1 (5%). CONCLUSION--Inspiratory muscle strength and nocturnal saturation data are correlated, but daytime SaO2 and FEV1 remain the most important predictors of nocturnal saturation.
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Selected References
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- Block A. J., Boysen P. G., Wynne J. W., Hunt L. A. Sleep apnea, hypopnea and oxygen desaturation in normal subjects. A strong male predominance. N Engl J Med. 1979 Mar 8;300(10):513–517. doi: 10.1056/NEJM197903083001001. [DOI] [PubMed] [Google Scholar]
- Bradley T. D., Mateika J., Li D., Avendano M., Goldstein R. S. Daytime hypercapnia in the development of nocturnal hypoxemia in COPD. Chest. 1990 Feb;97(2):308–312. doi: 10.1378/chest.97.2.308. [DOI] [PubMed] [Google Scholar]
- Connaughton J. J., Catterall J. R., Elton R. A., Stradling J. R., Douglas N. J. Do sleep studies contribute to the management of patients with severe chronic obstructive pulmonary disease? Am Rev Respir Dis. 1988 Aug;138(2):341–344. doi: 10.1164/ajrccm/138.2.341. [DOI] [PubMed] [Google Scholar]
- Fletcher E. C., Miller J., Divine G. W., Fletcher J. G., Miller T. Nocturnal oxyhemoglobin desaturation in COPD patients with arterial oxygen tensions above 60 mm Hg. Chest. 1987 Oct;92(4):604–608. doi: 10.1378/chest.92.4.604. [DOI] [PubMed] [Google Scholar]
- Fletcher E. C., Scott D., Qian W., Luckett R. A., Miller C. C., Goodnight-White S. Evolution of nocturnal oxyhemoglobin desaturation in patients with chronic obstructive pulmonary disease and a daytime PaO2 above 60 mm Hg. Am Rev Respir Dis. 1991 Aug;144(2):401–405. doi: 10.1164/ajrccm/144.2.401. [DOI] [PubMed] [Google Scholar]
- Gothe B., Hanekamp L. M., Cherniack N. S. Reproducibility of ventilatory measurements during sleep on different nights in patients with chronic obstructive pulmonary disease. J Lab Clin Med. 1987 May;109(5):608–616. [PubMed] [Google Scholar]
- Gould G. A., Gugger M., Molloy J., Tsara V., Shapiro C. M., Douglas N. J. Breathing pattern and eye movement density during REM sleep in humans. Am Rev Respir Dis. 1988 Oct;138(4):874–877. doi: 10.1164/ajrccm/138.4.874. [DOI] [PubMed] [Google Scholar]
- Heijdra Y. F., Dekhuijzen P. N., van Herwaarden C. L., Folgering H. T. Effects of body position, hyperinflation, and blood gas tensions on maximal respiratory pressures in patients with chronic obstructive pulmonary disease. Thorax. 1994 May;49(5):453–458. doi: 10.1136/thx.49.5.453. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hudgel D. W., Martin R. J., Capehart M., Johnson B., Hill P. Contribution of hypoventilation to sleep oxygen desaturation in chronic obstructive pulmonary disease. J Appl Physiol Respir Environ Exerc Physiol. 1983 Sep;55(3):669–677. doi: 10.1152/jappl.1983.55.3.669. [DOI] [PubMed] [Google Scholar]
- Johnson M. W., Remmers J. E. Accessory muscle activity during sleep in chronic obstructive pulmonary disease. J Appl Physiol Respir Environ Exerc Physiol. 1984 Oct;57(4):1011–1017. doi: 10.1152/jappl.1984.57.4.1011. [DOI] [PubMed] [Google Scholar]
- Rochester D. F., Braun N. M. Determinants of maximal inspiratory pressure in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1985 Jul;132(1):42–47. doi: 10.1164/arrd.1985.132.1.42. [DOI] [PubMed] [Google Scholar]
- Stradling J. R., Lane D. J. Nocturnal hypoxaemia in chronic obstructive pulmonary disease. Clin Sci (Lond) 1983 Feb;64(2):213–222. doi: 10.1042/cs0640213. [DOI] [PubMed] [Google Scholar]
- Stradling JR. Sleep studies for sleep-related breathing disorders. J Sleep Res. 1992 Dec;1(4):265–273. doi: 10.1111/j.1365-2869.1992.tb00049.x. [DOI] [PubMed] [Google Scholar]
- Tabachnik E., Muller N. L., Bryan A. C., Levison H. Changes in ventilation and chest wall mechanics during sleep in normal adolescents. J Appl Physiol Respir Environ Exerc Physiol. 1981 Sep;51(3):557–564. doi: 10.1152/jappl.1981.51.3.557. [DOI] [PubMed] [Google Scholar]
- Tatsumi K., Kimura H., Kunitomo F., Kuriyama T., Watanabe S., Honda Y. Sleep arterial oxygen desaturation and chemical control of breathing during wakefulness in COPD. Chest. 1986 Jul;90(1):68–73. doi: 10.1378/chest.90.1.68. [DOI] [PubMed] [Google Scholar]
- Vos P. J., Folgering H. T., van Herwaarden C. L. Nocturnal end-tidal PCO2 to detect apnoeas and hypopnoeas in sleep-disordered breathing. Physiol Meas. 1993 Nov;14(4):433–439. doi: 10.1088/0967-3334/14/4/004. [DOI] [PubMed] [Google Scholar]
- Wilson S. H., Cooke N. T., Edwards R. H., Spiro S. G. Predicted normal values for maximal respiratory pressures in caucasian adults and children. Thorax. 1984 Jul;39(7):535–538. doi: 10.1136/thx.39.7.535. [DOI] [PMC free article] [PubMed] [Google Scholar]