Work

Hypoxic burden and sleep hypoventilation in obese patients

Year: 2024

Type: article

Abstract: Introduction Novel biomarkers of hypoxic load have emerged, as sleep apnea-specific hypoxic burden which provides more precise assessment of intermittent hypoxemia severity. Our main objective was to assess the potential benefit of hypoxic burden to identify obesity-related sleep hypoventilation . We hypothesized that hypoxic burden may help diagnose obesity-related sleep hypoventilation better than usual sleep respiratory measures (i.e., apnea-hypopnea index (AHI), mean SpO 2 , time with SpO 2 < 90 %). Methods This retrospective study was conducted from June 2022 to October 2023 at the University Hospital of Rouen, France. All consecutive obese patients (BMI ≥30 kg/m 2 ), adults, with no other respiratory or neurological diseases who underwent a polysomnography or polygraphy with concomitant capnography were included. Sleep hypoventilation was defined according to American Academy of Sleep Medicine criteria based on transcutaneous CO 2 monitoring (PtcCO 2 ). Diagnostic performance of sleep-related respiratory measures i.e., sleep apnea-specific hypoxic burden, apnea-hypopnea index (AHI), mean SpO 2 , time with SpO 2 < 90 % was evaluated using Receiver Operating Characteristic (ROC) curves. Correlations between sleep-related respiratory measures were assessed by a Spearman correlation matrix. Results Among 107 obese patients with analyzed capnography, 37 (35 %) had sleep hypoventilation. Patients were 53 ± 14 years old, mean BMI = 38 ± 6 kg/m 2 , mean AHI = 26.5 ± 25/h, mean hypoxic burden = 67 ± 109 %min/h, mean SpO 2 = 91.5 ± 3 %, mean time with SpO 2 <90 % = 19.4 ± 28 %, mean PtcCO 2 = 6.2 ± 0.7 kPa. A low positive correlation was found between hypoxic burden and mean PtcCO 2 (r = 0.4, p < 0.001). Multivariate logistic regression model explaining sleep hypoventilation was insufficient with area under ROC curve of hypoxic burden estimated at 0.74 (95 % CI 0.65 to 0.84). Conclusion Hypoxic burden has low correlation with transcutaneous CO 2 pressure and a low ability to diagnose obesity-related sleep hypoventilation.

Source: Sleep Medicine

DOI: 10.1016/j.sleep.2024.09.007

Authors: L. Beauvais, A. Gillibert, A. Cuvelier, E. Artaud-Macari, M.-A. Melone

Institution: Institute for Research and Innovation in Biomedicine

Language: English

Topic: Obstructive Sleep Apnea Research

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,840