Quantification of Pulse Oximetry Tracings To Detect Obstructive Sleep Apnea in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 618A
Author(s):  
Marcel A. Baltzan ◽  
Adrienne S. Scott ◽  
Ryan Chan ◽  
Norman Wolkove
2014 ◽  
Vol 21 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Adrienne S Scott ◽  
Marcel A Baltzan ◽  
Norman Wolkove

Nocturnal hypoxemia and obstructive sleep apnea (OSA) are common comorbidities in patients with chronic obstructive pulmonary disease (COPD). The authors sought to develop a strategy to interpret nocturnal pulse oximetry and assess its capacity for detection of OSA in patients with stage 3 to stage 4 COPD. A review of consecutive patients with COPD who were clinically prescribed oximetry and polysomnography was conducted. OSA was diagnosed if the polysomnographic apnea-hypopnea index was >15 events/h. Comprehensive criteria were developed for interpretation of pulse oximetry tracings through iterative validation and interscorer concordance of ≥80%. Criteria consisted of visually identified desaturation ‘events’ (sustained desaturation ≥4%, 1 h time scale), ‘patterns’ (≥3 similar desaturation/saturation cycles, 15 min time scale) and the automated oxygen desaturation index. The area under the curve (AUC), sensitivity, specificity and accuracy were calculated. Of 59 patients (27 male), 31 had OSA (53%). The mean forced expiratory volume in 1 s was 46% of predicted (range 21% to 74% of predicted) and 52% of patients were on long-term oxygen therapy. Among 59 patients, 35 were correctly identified as having OSA or not having OSA, corresponding to an accuracy of 59%, with a sensitivity and specificity of 59% and 60%, respectively. The AUC was 0.57 (95% CI 0.55 to 0.59). Using software-computed desaturation events (hypoxemia ≥4% for ≥10 s) indexed at ≥15 events/h of sleep as diagnostic criteria, sensitivity was 60%, specificity was 63% and the AUC was 0.64 (95%CI 0.62 to 0.66). No single criterion demonstrated important diagnostic utility. Pulse oximetry tracing interpretation had a modest diagnostic value in identifying OSA in patients with moderate to severe COPD.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Osama Ibrahim Mohammad ◽  
Ahmed Gouda Elgazzar ◽  
Shymaa Mohammad Mahfouz ◽  
Marwa Elsayed Elnaggar

Abstract Background The conjunction of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is known as overlap syndrome (OS). The coexistence of these diseases has cardiovascular morbidity and mortality. The aim of this study is to assess the prevalence of OSA in COPD patients. One hundred COPD patients (obese and non-obese) performed sleep questionnaires and polysomnograms. Results OSA prevalence in COPD was 50% and it increases with increasing disease severity (P < 0.001). The highest prevalence of OSA was found in obese patients with severe COPD; 90.5% of these patients have OSA. In the OSA group, obese patients were found to have significantly higher STOP-Bang Questionnaire (SBQ), Epworth Sleep Scale (ESS), modified medical research council (mMRC) dyspnea scale, apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxygen desaturation index (ODI). Both obese and non-obese COPD patients showed significant positive correlations between AHI and smoking index (SI), SBQ, ESS, mMRC, ODI, and neck circumference (NC). Conclusions From this study, it can be concluded that moderate and severe COPD patients had a higher diagnosis of sleep-disordered breathing. Also, obese-COPD patients are more susceptible to develop OSA. Trial registration Name of the registry: Benha University Protocol Record Benha U123, Obstructive Sleep Apnea Prevalence in Patients With Chronic Obstructive Pulmonary Diseases. Trial registration number: NCT04903639. Date of registry: 5/22/2021 (retrospective study).


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