title: Can We Assess Pulsus Paradoxus through Polysomnography in a Patient with Chronic Obstructive Pulmonary Disease and Sleep-Disordered Breathing?
abstract: Pulsus paradoxus (PP) is a decrease in systolic blood pressure greater than 10 mm Hg during inspiration that occurs in various medical conditions. Using polysomnography pulse oximetry signal, photoplethysmography variations of the amplitude of the pulse pressure within the respiratory cycle were observed. There is a proportional relationship between the changes of inspiratory waveform values and the generated PP. A 59-year-old male underwent polysomnography that showed sleep hypoxemia, obstructive sleep-disordered breathing (apnea hypopnea index [AHI] = 5.1and respiratory disturbance index [RDI] = 87.9), with variations of pulse pressure induced primarily by inspiration. The highest variations in the pulse wave were observed in NREM sleep during obstructive respiratory events and in biocalibration during nasal breathing. The lowest variations occurred after the correction of inspiratory obstructive events and during biocalibration when asked to hold his breath.
authors.affiliation: Louisiana State University Health Science Center Sleep Disorders Center, Shreveport, LA.|Overton Brooks VA Medical Center Sleep Disorders Center, Shreveport, LA.
authors.forename: Cesar
authors.initials: C
authors.lastname: Liendo
authors.affiliation: Louisiana State University Health Science Center Sleep Disorders Center, Shreveport, LA.|Overton Brooks VA Medical Center Sleep Disorders Center, Shreveport, LA.
authors.forename: Ashtaad
authors.initials: A
authors.lastname: Dalal
authors.affiliation: Louisiana State University Health Science Center Sleep Disorders Center, Shreveport, LA.|Overton Brooks VA Medical Center Sleep Disorders Center, Shreveport, LA.
authors.forename: Esther
authors.initials: E
authors.lastname: Hinds
authors.affiliation: Louisiana State University Health Science Center Sleep Disorders Center, Shreveport, LA.|Overton Brooks VA Medical Center Sleep Disorders Center, Shreveport, LA.
authors.forename: Samreena
authors.initials: S
authors.lastname: Sara
authors.affiliation: Louisiana State University Health Science Center Sleep Disorders Center, Shreveport, LA.|Overton Brooks VA Medical Center Sleep Disorders Center, Shreveport, LA.
authors.forename: Oleg
authors.initials: O
authors.lastname: Chernyshev
authors.affiliation: Louisiana State University Health Science Center Sleep Disorders Center, Shreveport, LA.|Overton Brooks VA Medical Center Sleep Disorders Center, Shreveport, LA.
authors.forename: Swathi
authors.initials: S
authors.lastname: Nutakki
authors.affiliation: Clinica Anglo Americana, Lima Peru School of Medicine Professor, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Jorge Rey
authors.initials: JR
authors.lastname: de Castro
authors.affiliation: Louisiana State University Health Science Center Sleep Disorders Center, Shreveport, LA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Chesson
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology*; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000503:physiopathology*
keywords: chronic obstructive pulmonary disease; inspiratory flow limitation event; photoplethysmography; pulsus paradoxus; sleep-disordered breathing