Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/2986
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Type: Journal article
Title: Sleep hypoventilation in hypercapnic chronic obstructive pulmonary disease: prevalence and associated factors
Author: O'Donoghue, F.
Catcheside, P.
Ellis, E.
Grunstein, R.
Pierce, R.
Rowland, L.
Collins, E.
Rochford, S.
McEvoy, R.
Citation: European Respiratory Journal, 2003; 21(6):977-984
Publisher: European Respiratory Soc Journals Ltd
Issue Date: 2003
ISSN: 0903-1936
1399-3003
Abstract: Sleep hypoventilation (SH) may be important in the development of hypercapnic respiratory failure in chronic obstructive pulmonary disease (COPD). The prevalence of SH, associated factors, and overnight changes in waking arterial blood gases (ABG), were assessed in 54 stable hypercapnic COPD patients without concomitant sleep apnoea or morbid obesity. Lung function assessment, anthropomorphic measurements, and polysomnography with ABG measurement before and after sleep were conducted in all patients. Transcutaneous carbon dioxide tension (Pt,CO2) was measured in sleep, using simultaneous arterial carbon dioxide tension (Pa,CO2) for in vivo calibration and to correct for drift in the sensor. Of the patients, 43% spent > or = 20% of sleep time with Pt,CO2 > 1.33 kPa (10 mmHg) above waking baseline. Severity of SH was best predicted by a combination of baseline Pa,CO2, body mass index and per cent rapid-eye movement (REM) sleep. REM-related hypoventilation correlated significantly with severity of inspiratory flow limitation in REM, and with apnoea/hypopnoea index. Pa,CO2 increased mean+/-SD 0.70+/-0.65 kPa (5.29+/-4.92 mmHg) from night to morning, and this change was highly significant. The change in Pa,CO2 was strongly correlated with severity of SH. Sleep hypoventilation is common in hypercapnic chronic obstructive pulmonary disease, and related to baseline arterial carbon dioxide tension, body mass index and indices of upper airway obstruction. Sleep hypoventilation is associated with significant increases in arterial carbon dioxide tension night-to-morning, and may contribute to long-term elevations in arterial carbon dioxide tension.
Keywords: Australian trial of Noninvasive Ventilation in Chronic Airflow Limitation investigators; Humans; Pulmonary Disease, Chronic Obstructive; Hypoventilation; Hypercapnia; Respiratory Function Tests; Blood Gas Analysis; Polysomnography; Anthropometry; Severity of Illness Index; Prevalence; Risk Factors; Circadian Rhythm; Aged; Middle Aged; Female; Male; Sleep Wake Disorders
RMID: 0020032392
DOI: 10.1183/09031936.03.00066802
Appears in Collections:Molecular and Biomedical Science publications

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