Night-to-night variation of the oxygen desaturation index in sleep apnoea syndrome

Fietze, Ingo; Dingli, K; Diefenbach, Konstanze; Douglas, N. J.; Glos, Martin; Tallafuss, M; Terhalle, W; Witt, Christian

doi:10.1183/09031936.04.00100203

Cited by 83 publications

(58 citation statements)

References 19 publications

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“…This variability was demonstrated in COPD patients, both night-to-night and over a 3-week period of clinical stability [25]. However, in most obstructive sleep apnea syndrome patients, oxygen desaturation index variability is rather modest and screening can be reliably based on a single, 1-night recording [26]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Heterogeneity among Patients with Obesity Hypoventilation Syndrome: Therapeutic Implications

et al. 2007

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Background: Obesity hypoventilation syndrome (OHS) can be treated with noninvasive positive pressure ventilation (NIPPV). Once clinical stability is achieved, continuous positive airway pressure (CPAP) can be recommended in many cases. However, some patients respond only partially to CPAP and NIPPV is a better option for them. Objectives: To assess treatment effectiveness in 2 groups of patients: those who could be switched to CPAP after polysomnographic titration and those who required NIPPV. Methods: A prospective study of 24 OHS patients was conducted, 11 were treated with CPAP and 13 with NIPPV. Morning and evening arterial blood gases were measured. Daytime and overnight oximetric recordings were performed. A post hoc analysis compared both groups. Results: Neither group exhibited deterioration on morning-to-evening blood gases. All patients in the CPAP group presented SaO₂ of less than 90% (CT90%) for <15% of the time on nocturnal and daytime recordings. In the NIPPV group, 8 patients had either daytime or nocturnal CT90% ≧15%. There were no intergroup differences regarding age, body mass index, Epworth scale values or PaO₂/PaCO₂ prior to treatment. FVC in the NIPPV group was lower than in the CPAP group (p = 0.01). Apnea-hypopnea index was higher (56 ± 23 vs. 36 ± 23, p = 0.049) and baseline CT90% was lower (76 ± 19% vs. 92 ± 14%, p = 0.03) in the CPAP group. Conclusions: Two patient subtypes can be identified. Those controlled with CPAP have better spirometry and a significantly higher apnea-hypopnea index. None of these patients showed daytime hypoxemia and all exhibited satisfactory overnight oxygenation. However, 61% of the NIPPV group had suboptimal oximetry results. Nocturnal/diurnal oximetries should be made to assess treatment efficacy in stable OHS patients who fail to achieve good control with CPAP.

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Section: Discussionmentioning

confidence: 99%

Clinical Heterogeneity among Patients with Obesity Hypoventilation Syndrome: Therapeutic Implications

et al. 2007

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“…In a study of a population with low prevalence of OSAHS using clinical assessment and home oximetry a Se of 40% and a Sp of 98% were found for ODI >15 (25). In another study, the BTS pulse oximetry criteria had high Sp (100%) when positive, but rather low Se (31%) in patients with no significant desaturations but hypopneas (26). When we analysed the predictive values of oximetry according to the severity of the disease, they were very low in mild and then moderate OSAHS.…”

Section: Discussionmentioning

confidence: 95%

During economic crisis can sleep questionnaires improve the value of oximetry for assessing sleep apnea?

et al. 2016

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Background: The diagnosis of obstructive sleep apnea/hypopnea syndrome (OSAHS) is essential but polysomnography (PSG) is expensive and time consuming. Oximetry has been used as a less expensive indicator of OSAHS. The aim of the study was to evaluate the clinical utility of the combination of oximetry with four different questionnaires: Stop, Stop Bang (S-B), Berlin questionnaire (BQ), Epworth Sleepiness Scale (ESS) in order to identify patients at risk for OSAHS compared with in-laboratory PSG.Methods: Patients visiting a sleep clinic were prospectively studied. They completed Stop, S-B, BQ and ESS.Home oximetry and in laboratory PSG were performed within 3-20 days.Results: A total of 204 patients were included in the study (77.5% males, mean age 51.8±13.8 years, BMI 32.8±6.2 kg/m 2 , SaO 2 % awake 95.7±2). S-B had the highest sensitivity (Se) (97.5%) and negative predictive value (NPV) (62.5%) but the lowest specificity (Sp) (9%), whereas ESS had the best Sp (75%) and positive predictive values (PPV) (81.4%). The predictive values of questionnaires improved as the severity of OSAHS worsened. The predictive values of oximetry were high for severe but low for mild and moderate OSAHS. For that oximetry was combined with different sleep questionnaires in different OSAHS severity groups, but with no improvement in the predictive values.Conclusions: Oximetry may be used as a tool for identifying severe OSAHS. For mild and moderate disease the combination of questionnaires did not improve the diagnostic accuracy and especially for symptomatic patients with negative results, the need of PSG is essential.

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“…Glomerular filtration rate (GFR) was estimated using an established method proposed by a working group of the Japanese Chronic Kidney Disease Initiative [9]. A pulse oximeter (PULSOX-Me300, KONICA MINOLTA, INC, Osaka, Japan) was used to measure 3 % oxygen desaturation index (ODI), and sleep apnea syndrome was diagnosed as a 3 % ODI of C15 events/h, as described in a previous study [10], since a 3 % ODI C15 events/h was considered equivalent to an apneahypopnea index (AHI) C20 events/h as determined by PSG, with a recommendation for treatment with CPAP for subjects showing AHI C20 events/h [11][12][13].…”

Section: Data Collection and Laboratory Measurementsmentioning

confidence: 99%

Serum triglyceride levels in relation to high-density lipoprotein cholesterol (TG-HDL) ratios as an efficient tool to estimate the risk of sleep apnea syndrome in non-overweight Japanese men

Shimizu

Yoshimine

Nagayoshi

et al. 2016

Environ Health Prev Med

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Objectives Several studies have reported the association between sleep apnea syndrome and insulin resistance. Being overweight is known risk factor both for sleep apnea syndrome and insulin resistance. However, no studies have reported on the association between serum triglyceride levels in relation to high-density lipoprotein cholesterol (TG-HDL) ratios (a marker of insulin resistance) and sleep apnea syndrome accounting for body mass index (BMI) status. Methods Subjects for the present cross-sectional study consisted of 1,528 men aged 30-69 years undergoing pulse oximetry at a sleep disorders clinic for sleep apnea syndrome. Sleep apnea syndrome was diagnosed as a 3 % oxygen desaturation index (ODI) of C15 events/h. Results Among study participants, 241 men were diagnosed with sleep apnea syndrome. Independent of classical cardiovascular risk factors, TG-HDL was significantly positively associated with sleep apnea syndrome in participants with a BMI \25 kg/m 2 , but not in participants with a BMI C25 kg/m 2 . The multivariable adjusted odds ratio (OR) and 95 % confidence interval (95 % CI) of sleep apnea syndrome per Log TG-HDL was 2.03 (95 % CI: 1.36-3.03) for a BMI \25 kg/m 2 and 1.23 (95 % CI: 0.89-1.70) for a BMI C25 kg/m 2 . Conclusions An independent positive association between TG-HDL levels and risk of sleep apnea syndrome was observed in participants with a BMI of \25 kg/m 2 , but not in participants with a BMI C25 kg/m 2 . TG-HDL levels could be an efficient tool to estimate the risk of sleep apnea syndrome in non-overweight Japanese men.

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Night-to-night variation of the oxygen desaturation index in sleep apnoea syndrome

Cited by 83 publications

References 19 publications

Clinical Heterogeneity among Patients with Obesity Hypoventilation Syndrome: Therapeutic Implications

Clinical Heterogeneity among Patients with Obesity Hypoventilation Syndrome: Therapeutic Implications

During economic crisis can sleep questionnaires improve the value of oximetry for assessing sleep apnea?

Serum triglyceride levels in relation to high-density lipoprotein cholesterol (TG-HDL) ratios as an efficient tool to estimate the risk of sleep apnea syndrome in non-overweight Japanese men

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