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Daytime hypercapnia in obstructive sleep apnea syndrome
Naoko Kawata1, Koichiro Tatsumi, Jiro Terada
1Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan.
Chest
|December 15, 2007
Summary
Daytime hypercapnia affects 14% of patients with obstructive sleep apnea syndrome (OSAS). Higher apnea-hypopnea index (AHI) predicts this condition, which can improve with CPAP therapy.
Area of Science:
- Pulmonary Medicine
- Sleep Medicine
- Critical Care Medicine
Background:
- Daytime hypercapnia (elevated Paco2) is observed in some patients with obstructive sleep apnea syndrome (OSAS).
- The direct link between OSAS and daytime hypercapnia, despite its presence in only a subset of patients, warrants further investigation.
Purpose of the Study:
- To determine the prevalence of daytime hypercapnia in OSAS patients.
- To examine associations between daytime hypercapnia and obesity, airflow limitation, lung restriction, and sleep apnea severity.
- To assess the effectiveness of continuous positive airway pressure (CPAP) therapy.
Main Methods:
- Polysomnography was used to evaluate 1,227 OSAS patients.
- Patients were categorized based on daytime Paco2 levels and response to CPAP therapy.
Main Results:
- 14% of OSAS patients had daytime hypercapnia.
- Higher body mass index (BMI) and apnea-hypopnea index (AHI) were associated with hypercapnia.
- AHI was a significant predictor; BMI and %VC were borderline predictors.
- CPAP therapy corrected daytime hypercapnia in 51% of severe OSAS patients.
Conclusions:
- Daytime hypercapnia in OSAS may stem from the sleep apnea itself in a specific patient subgroup.
- Sleep apnea severity, indicated by AHI, is a key factor in developing daytime hypercapnia.
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