Nocturnal hypoxaemia in severe scoliosis

The relationship between spirometry and daytime blood gases on the one hand and hypoxaemia during sleep on the other was studied in 13 patients with severe thoracic scoliosis. Eight patients had hypoxaemia (mean Sao2 less than 90%) during sleep. They were characterized by a lower vital capacity (30 versus 50% of predicted, P less than 0.01) and by a greater fall in vital capacity from sitting to supine (26 versus 7% of sitting VC, P less than 0.05). All patients with hypoxaemia during sleep were hypercapnic during the daytime. The fall in Sao2 with sleep was related to the increase in transcutaneous PCO2, indicating hypoventilation as the main mechanism behind hypoxaemia during sleep in scoliosis patients.