title: Sleep disordered breathing in patients with chronic obstructive pulmonary disease.
abstract: Sleep-related disordered breathing (SDB) and its influence on desaturation were examined in stable COPD patients with waking SpO2 > 90%. With respiratory inductance plethysmography, thoracic-abdominal respiratory movements for all events with more than 4% desaturation were analyzed in 26 patients. Types of SDB were confirmed by full polysomnography. Irregular breathing induced desaturation, while stable respiration continued during some desaturation events. Three types of altered ventilation were observed: hypoventilation, paradoxical movement and periodic breathing. An unusual type of paradoxical movement, with normal airflow despite progressive desaturation, was observed in REM sleep. Patients were divided into desaturation (15 patients) and non-desaturation (11 patients) groups. Daytime arterial blood gas, lung function values, and 6-min walking distance did not differ. Awake, mode, maximum and minimum nocturnal SpO2 were lower in the desaturation group. SDB-induced desaturation events in the desaturation group were more frequent (9.2+/-3.5 vs. 1.8+/-2.2 times), a greater SpO2 decrease (11.4+/-7.1% vs. 5.2+/-2.1%) and longer duration (73.2+/-34.8 vs. 18.8+/-39.0 min). Patterns of SDB in the desaturation group were hypoventilation (74.4+/-23.4%), paradoxical movement (10.2+/-14.5%), periodic breathing (12.1+/-18.3%) and unclassified (5.8+/-11.2%). These results reveal that lower SpO2 and SDB influence nocturnal desaturation in stable COPD patients.
authors.affiliation: Respiratory Division, Department of Internal Medicine, Saiseikai Central Hospital, Mita 1-4-17, Minato-ku, Tokyo 108-0073, Japan. ZWQ00221@nifty.ne.jp
authors.forename: Takuya
authors.initials: T
authors.lastname: Aoki
authors.forename: Ebihara
authors.initials: E
authors.lastname: Akinori
authors.forename: Yurika
authors.initials: Y
authors.lastname: Yogo
authors.forename: Fumio
authors.initials: F
authors.lastname: Sakamaki
authors.forename: Yukio
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Keiichi
authors.initials: K
authors.lastname: Suemasu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001784:Blood Gas Analysis; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010992:Plethysmography, Impedance; D017286:Polysomnography; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D015656:Respiratory Mechanics / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000097:blood* / Q000209:etiology / Q000503:physiopathology*