Sleep Disordered Breathing in Patients with Chronic Obstructive Pulmonary Disease

Aoki, Takuya; Ebihara, Akinori; Yogo, Yurika; Sakamaki, Fumio; Suzuki, Yukio; Suemasu, Keiichi

doi:10.1081/copd-200057606

Cited by 5 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sleep-related disordered breathing (SDB) and nocturnal desaturations have been reported in COPD patients, giving rise to an “overlap syndrome” although not all SDB could be classified as frank sleep apnea [45, 46]. We were careful, however, in excluding subjects with symptoms of sleep apnea in both cohorts.…”

Section: Discussionmentioning

confidence: 99%

Expiratory Flow Limitation in Obstructive Sleep Apnea and COPD: A Quantitative Method to Detect Pattern Differences Using the Negative Expiratory Pressure Technique

Baydur

Vigen

Chen³

2012

TORMJ

View full text Add to dashboard Cite

Background:Expiratory flow limitation (EFL), determined by the negative expiratory pressure (NEP) technique, can exhibit overlapping patterns in COPD, obstructive sleep apnea (OSA) and non-OSA obesity. We assessed the ability of a quantitative method to assess EFL to discriminate COPD from obese and OSA patients during NEP (-2 to -3 cm H2O) testing.Methods:EFL was quantified by measuring the area under the preceding control tidal breath (Vt) subtended by the NEP curve (%AUC). To quantify mean lost flow, the ratio of %AUC to percentage of control Vt over which EFL occurred (%EFL) (= %AUC/%EFL) was computed. Percent EFL, %AUC, and %AUC/%EFL was compared in 42 patients with COPD, 28 obese subjects without OSA, 50 with OSA (26 mild-moderate, 24 severe) and 19 control subjects, in seated and supine postures.Results:All patients exhibited %EFL values significantly higher than control subjects, corrected for age and gender (ANOVA). All but the COPD group exhibited higher %EFL while supine, but not %AUC or %AUC/%EFL. Amongst seated subjects, %EFL was highest in COPD, and amongst supine groups, it was greatest in OSA and COPD. %AUC/%EFL was significantly higher in mild-moderate OSA than in COPD only while seated. %AUC or %AUC/%EFL did not discriminate amongst other cohorts in either posture.Conclusions:Computation of %EFL helps distinguish EFL in COPD, obese and OSA patients from those of control subjects. Computation of %AUC and %AUC/%EFL is useful in determining the magnitude of extrathoracic FL in individuals with obesity and OSA, but does not distinguish between cohorts.

show abstract

Section: Discussionmentioning

confidence: 99%

Expiratory Flow Limitation in Obstructive Sleep Apnea and COPD: A Quantitative Method to Detect Pattern Differences Using the Negative Expiratory Pressure Technique

Baydur

Vigen

Chen³

2012

TORMJ

View full text Add to dashboard Cite

show abstract

“…1 Over time, untreated OSA can result in multiple negative sequelae, including significant daytime hypersomnolence, cardiovascular disease such as hypertension, neurocognitive dysfunction, pulmonary disorders, and decreased quality of life. [2][3][4][5] The gold standard test for the diagnosis of OSA is currently polysomnography, 6 and continuous positive airway pressure (CPAP) has been first-line therapy for OSA since it was first described by Sullivan in 1981. 7 Moderate and severe sleep apneas are also associated with numerous medical comorbidities including hypertension, stroke, and diabetes, and therefore have the potential to complicate ambulatory and inpatient treatment for these patients.…”

Section: Introductionmentioning

confidence: 99%

Financial incentive of home continuous positive airway pressure machine use in the inpatient hospital setting

Spiceland

Pringle

et al. 2014

The Laryngoscope

View full text Add to dashboard Cite

This is the first study to characterize the magnitude of cost savings from utilization of home versus hospital-provided CPAP machines in patients requiring inpatient CPAP machine use. The use of patient-owned CPAP machines may reflect an opportunity to provide cheaper care while maintaining high patient safety and quality care. The actual economic impact to an individual hospital would vary based on the insurance payer mix.

show abstract

“…Undiagnosed OSA with or without symptoms has been independently associated with an increased likelihood of systemic hypertension, 2 cardiovascular disease, 3 stroke, and diminished quality of life. 4,5 In addition, there is a well-recognized association between OSA, sleepiness, and automobile accidents in both commercial and noncommercial drivers. 6,7 Severe sleep apnea causes oxygen desaturation, which triggers a catecholamine surge and elevations in blood pressure.…”

mentioning

confidence: 99%

“…3,4 It has been recognized that the combination of chronic obstructive pulmonary disease and sleep apnea worsens gas-exchange abnormalities during sleep in patients with chronic obstructive pulmonary disease, leading to increased morbidity. 5 In effect, SDB is associated with a myriad of systemic complications.In contrast with the wealth of descriptive information regarding SDB in the outpatient setting, relatively little is known regarding SDB in acutely ill patients. Most studies note the effect of the inpatient setting on sleep quality and quantity.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Sleep Disordered Breathing in Hospitalized Patients

Goring

Collop²

2008

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

S leep disordered breathing (SDB) is a prevalent problem with clinical expression ranging from snoring to severe obstructive sleep apnea (OSA). The OSA syndrome affects at least 5% of the adult population. 1 A growing body of literature attests to significant morbidity associated with even mild OSA. Undiagnosed OSA with or without symptoms has been independently associated with an increased likelihood of systemic hypertension, 2 cardiovascular disease, 3 stroke, and diminished quality of life. 4,5 In addition, there is a well-recognized association between OSA, sleepiness, and automobile accidents in both commercial and noncommercial drivers. 6,7 Severe sleep apnea causes oxygen desaturation, which triggers a catecholamine surge and elevations in blood pressure. 4 This can lead to decompensated congestive heart failure (CHF) and acute stroke in the susceptible indvidiual. 3,4 It has been recognized that the combination of chronic obstructive pulmonary disease and sleep apnea worsens gas-exchange abnormalities during sleep in patients with chronic obstructive pulmonary disease, leading to increased morbidity. 5 In effect, SDB is associated with a myriad of systemic complications.In contrast with the wealth of descriptive information regarding SDB in the outpatient setting, relatively little is known regarding SDB in acutely ill patients. Most studies note the effect of the inpatient setting on sleep quality and quantity. 8 Other studies have described a high frequency of arrhythmias in subjects with SDB. 9 To date, there is no description of the association between SDB and acute exacerbations of cardiopulmonary disease in a large inpatient population. The primary aims of this study are to assess the prevalence of SDB in patients referred for inpatient polysomnography in a tertiary care center and to assess the odds of association of SDB with the underlying acute illness, as well as with patient characteristics. A secondary aim is to evaluate the quality of sleep and type of apneas in the sample. MethodsThe study involved a retrospective chart review of polysomnographic reports and medical records of all patients who had studies done while hospitalized at Johns Hopkins Hospital or Bayview Medical Center between January 2003 and September 2004. Consent for this project was obtained from the Johns Hopkins Institutional Review Board.Total sleep time, sleep stages, sleep efficiency, the presence of SDB, type of apnea, and occurrence of hypoxemia and arrhythmias were noted. Body mass index (BMI) and inpatient

show abstract

Sleep Disordered Breathing in Patients with Chronic Obstructive Pulmonary Disease

Cited by 5 publications

References 0 publications

Expiratory Flow Limitation in Obstructive Sleep Apnea and COPD: A Quantitative Method to Detect Pattern Differences Using the Negative Expiratory Pressure Technique

Expiratory Flow Limitation in Obstructive Sleep Apnea and COPD: A Quantitative Method to Detect Pattern Differences Using the Negative Expiratory Pressure Technique

Financial incentive of home continuous positive airway pressure machine use in the inpatient hospital setting

Sleep Disordered Breathing in Hospitalized Patients

Contact Info

Product

Resources

About