Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables
ABSTRACT Objective: To infer the prevalence and variables predictive of isolated nocturnal hypoxemia and obstructive sleep apnea (OSA) in patients with COPD and mild hypoxemia. Methods: This was a cross-sectional study involving clinically stable COPD outpatients with mild hypoxemia (oxygen satura...
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Sociedade Brasileira de Pneumologia e Tisiologia
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| Series: | Jornal Brasileiro de Pneumologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132017000300176&lng=en&tlng=en |
| _version_ | 1818340405291253760 |
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| author | José Laerte Rodrigues Silva Júnior Marcus Barreto Conde Krislainy de Sousa Corrêa Helena Rabahi Arthur Alves Rocha Marcelo Fouad Rabahi |
| author_facet | José Laerte Rodrigues Silva Júnior Marcus Barreto Conde Krislainy de Sousa Corrêa Helena Rabahi Arthur Alves Rocha Marcelo Fouad Rabahi |
| author_sort | José Laerte Rodrigues Silva Júnior |
| collection | DOAJ |
| description | ABSTRACT Objective: To infer the prevalence and variables predictive of isolated nocturnal hypoxemia and obstructive sleep apnea (OSA) in patients with COPD and mild hypoxemia. Methods: This was a cross-sectional study involving clinically stable COPD outpatients with mild hypoxemia (oxygen saturation = 90-94%) at a clinical center specializing in respiratory diseases, located in the city of Goiânia, Brazil. The patients underwent clinical evaluation, spirometry, polysomnography, echocardiography, arterial blood gas analysis, six-minute walk test assessment, and chest X-ray. Results: The sample included 64 patients with COPD and mild hypoxemia; 39 (61%) were diagnosed with sleep-disordered breathing (OSA, in 14; and isolated nocturnal hypoxemia, in 25). Correlation analysis showed that PaO2 correlated moderately with mean sleep oxygen saturation (r = 0.45; p = 0.0002), mean rapid eye movement (REM) sleep oxygen saturation (r = 0.43; p = 0.001), and mean non-REM sleep oxygen saturation (r = 0.42; p = 0.001). A cut-off point of PaO2 ≤ 70 mmHg in the arterial blood gas analysis was significantly associated with sleep-disordered breathing (OR = 4.59; 95% CI: 1.54-13.67; p = 0.01). The model showed that, for identifying sleep-disordered breathing, the cut-off point had a specificity of 73.9% (95% CI: 51.6-89.8%), a sensitivity of 63.4% (95% CI: 46.9-77.9%), a positive predictive value of 81.3% (95% CI: 67.7-90.0%), and a negative predictive value of 53.1% (95% CI: 41.4-64.4%), with an area under the ROC curve of 0.69 (95% CI: 0.57-0.80), correctly classifying the observations in 67.2% of the cases. Conclusions: In our sample of patients with COPD and mild hypoxemia, the prevalence of sleep-disordered breathing was high (61%), suggesting that such patients would benefit from sleep studies. |
| first_indexed | 2024-12-13T15:42:22Z |
| format | Article |
| id | doaj.art-d688f9a839124d1ca59faf0d7e4950d0 |
| institution | Directory Open Access Journal |
| issn | 1806-3756 |
| language | English |
| last_indexed | 2024-12-13T15:42:22Z |
| publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
| record_format | Article |
| series | Jornal Brasileiro de Pneumologia |
| spelling | doaj.art-d688f9a839124d1ca59faf0d7e4950d02022-12-21T23:39:48ZengSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia1806-375643317618210.1590/s1806-37562016000000051S1806-37132017000300176Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variablesJosé Laerte Rodrigues Silva JúniorMarcus Barreto CondeKrislainy de Sousa CorrêaHelena RabahiArthur Alves RochaMarcelo Fouad RabahiABSTRACT Objective: To infer the prevalence and variables predictive of isolated nocturnal hypoxemia and obstructive sleep apnea (OSA) in patients with COPD and mild hypoxemia. Methods: This was a cross-sectional study involving clinically stable COPD outpatients with mild hypoxemia (oxygen saturation = 90-94%) at a clinical center specializing in respiratory diseases, located in the city of Goiânia, Brazil. The patients underwent clinical evaluation, spirometry, polysomnography, echocardiography, arterial blood gas analysis, six-minute walk test assessment, and chest X-ray. Results: The sample included 64 patients with COPD and mild hypoxemia; 39 (61%) were diagnosed with sleep-disordered breathing (OSA, in 14; and isolated nocturnal hypoxemia, in 25). Correlation analysis showed that PaO2 correlated moderately with mean sleep oxygen saturation (r = 0.45; p = 0.0002), mean rapid eye movement (REM) sleep oxygen saturation (r = 0.43; p = 0.001), and mean non-REM sleep oxygen saturation (r = 0.42; p = 0.001). A cut-off point of PaO2 ≤ 70 mmHg in the arterial blood gas analysis was significantly associated with sleep-disordered breathing (OR = 4.59; 95% CI: 1.54-13.67; p = 0.01). The model showed that, for identifying sleep-disordered breathing, the cut-off point had a specificity of 73.9% (95% CI: 51.6-89.8%), a sensitivity of 63.4% (95% CI: 46.9-77.9%), a positive predictive value of 81.3% (95% CI: 67.7-90.0%), and a negative predictive value of 53.1% (95% CI: 41.4-64.4%), with an area under the ROC curve of 0.69 (95% CI: 0.57-0.80), correctly classifying the observations in 67.2% of the cases. Conclusions: In our sample of patients with COPD and mild hypoxemia, the prevalence of sleep-disordered breathing was high (61%), suggesting that such patients would benefit from sleep studies.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132017000300176&lng=en&tlng=enPulmonary disease, chronic obstructive/complicationsSleep wake disorders/epidemiologyAnoxia/etiology |
| spellingShingle | José Laerte Rodrigues Silva Júnior Marcus Barreto Conde Krislainy de Sousa Corrêa Helena Rabahi Arthur Alves Rocha Marcelo Fouad Rabahi Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables Jornal Brasileiro de Pneumologia Pulmonary disease, chronic obstructive/complications Sleep wake disorders/epidemiology Anoxia/etiology |
| title | Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables |
| title_full | Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables |
| title_fullStr | Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables |
| title_full_unstemmed | Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables |
| title_short | Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables |
| title_sort | sleep disordered breathing in patients with copd and mild hypoxemia prevalence and predictive variables |
| topic | Pulmonary disease, chronic obstructive/complications Sleep wake disorders/epidemiology Anoxia/etiology |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132017000300176&lng=en&tlng=en |
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