Nocturnal Oxyhemoglobin Desaturation in COPD Patients with Arterial Oxygen Tensions Above 60 mm Hg

Chronic Obstructive Pulmonary Disease and Sleep Quality

“…COPD patients develop hypoxia and hypercapnia of varying degrees depending on the severity of their lung disease; hyperinflation occurs in the lungs due to air trapping and work of breathing increases [3]. Oxygen desaturation among the COPD patients is probably caused by physiologic hypoventilation that occurs during sleep precipitating a considerable decrease in the SaO 2 level of hypoxemic patients [28,34,35]. Hypoventilation during sleep is related to impairment of the respiratory center's response to chemical, mechanical and cortical stimuli [26,36,37].…”

Long-term oxygen therapy in COPD patients with moderate hypoxaemia: does it add years to life?

“…It was suggested that nocturnal desaturations may precipitate the development of cor pulmonale [22,23]. Although consecutive investigations by FLETCHER et al [21,24,25] seemed to support such a hypothesis, more recent studies by CHAOUAT et al [26] did not confirm that patients who desaturate during sleep present with higher pulmonary arterial pressure, than wellmatched patients who do not desaturate during sleep. There is one study suggesting improved survival in "desaturators" treated with oxygen compared with "desaturators" from the control group [27].…”

“…The rationale for nocturnal oxygen supplementation is based on clinical observations that many COPD patients with a satisfactory Pa,O 2 while resting and awake desaturate during sleep, especially during rapid eye movement (REM) sleep [20,21]. It was suggested that nocturnal desaturations may precipitate the development of cor pulmonale [22,23].…”

“…Around one-third of COPD patients with satisfactory oxygenation during the day desaturate overnight [21]. One may assume that such patients were also included in both studies mentioned above and that they were breathing oxygen during sleep.…”

Chronic Obstructive Pulmonary Disease and Sleep

“…Uyanıkken hafif hipoksemi görülen hastalarda pulmoner hipertansiyonun gelişiminde geceleyin oluşan noktürnal oksijen desatürasyonu rol oynamaktadır. 26 Ventilasyon/perfüzyon uyumsuzluğu Uykuda, özellikle REM döneminde, yardımcı solunum kaslarının solunuma katkıları azaldığından FRK de azalmakta, V ' /Q ' kötüleşmekte ve hipoksemi derinleşmektedir. KOAH hastalarında hiperinflasyon sonucu diyaframın kasılma etkinliği azalmaktadır.…”