2003 OPEN FORUM Abstracts
SLEEP-BREATHING DISORDERS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE BEFORE AND AFTER BILEVEL POSITIVE AIRWAY PRESSURE
GUO Xiheng, Chen W, Hongyu Z, Weimin K, Li A, Li L, Xinzhi W
Beijing Chaoyang Hospital-Beijing Institute of Respiratory Medicine
Affiliated Capital University of Medical Sciences
Beijing 100020, P.R. China
Objective In order to study sleep-breathing disorders in patients with chronic obstructive pulmonary disease,
Methods: 72 consecutive patients ( male 55,female 17, mean aged 63.4±10.1 yrs BMI 27.3±3.4) with confirmed diagnosis of COPD in steady-state were recruited for nocturnal polysomnogram (PSG). 40 normal subjects with matched sex, age and BMI as control.
RESULTS: 72 COPD patients showed remarkably sleep hypoxemia and abnormal sleep architecture (higher percentage of NREM stage 1+2, lower percentage of slow wave sleep(SWS) and REM sleep significantly). 46 OSAHS in COPD study population, named overlap syndrome, with mean AHI 33.1±13.3, and mean SaO22 decreased from 86.8%±10.5% to 73.5%±13.8% (p<0.01)during sleep. Sleep architecture was abnormal more significantly than that of simple COPD. Bilevel positive airway pressure and oxygen therapy decreased AHI (p<0.001), improved SaO2 (p<0.05) and sleep architecture effectively in patients with overlap syndrome. Nocturnal oxygen therapy improved sleep quality(SWS p<0.05) and hypoxemia(p<0.05) in patients with simple COPD.
CONCLUSION: Sleep hypoxemia, apnea and sleep disturbance are common in COPD population and may be potential important disadvantage factors influence COPD prognosis. Early diagnosis and effective management are important.