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Pulmonary hypertension in obstructive sleep apnoea

L Laks1, B Lehrhaft, R R Grunstein

  • 1Sleep Disorders Centre, Royal Prince Alfred Hospital, Camperdown, Australia.

The European Respiratory Journal
|April 1, 1995
PubMed
Summary

Pulmonary hypertension is common in patients with moderate to severe obstructive sleep apnoea (OSA), particularly those with chronic airflow limitation (CAL). Daytime hypoxemia is not always present in these patients.

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Area of Science:

  • Cardiopulmonary Medicine
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Obstructive sleep apnoea (OSA) is a prevalent sleep-disordered breathing condition.
  • Pulmonary hypertension (PH) is a known complication of severe OSA.
  • The relationship between OSA severity, chronic airflow limitation (CAL), and PH requires further elucidation.

Purpose of the Study:

  • To investigate the prevalence and associated factors of pulmonary hypertension in patients with obstructive sleep apnoea.
  • To assess the correlation between pulmonary artery pressure, lung function, and arterial blood gas parameters in OSA patients.

Main Methods:

  • Pulmonary artery pressure, lung function (FEV1), and arterial blood gases (PaO2, PaCO2) were measured in 100 consecutive OSA patients (RDI > 20).

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  • Patients were stratified based on the presence of significant chronic airflow limitation (CAL).

    • Main Results:

    • 42% of OSA patients exhibited awake pulmonary artery pressure > 20 mmHg.
    • Patients with PH were older and had higher PaCO2, lower PaO2, and lower FEV1 compared to normotensive patients.
    • PaO2, PaCO2, and FEV1 significantly correlated with pulmonary artery pressure, collectively explaining 33% of its variability.

    Conclusions:

    • Pulmonary hypertension is frequent in moderate to severe OSA, especially with coexisting CAL.
    • Daytime hypoxemia is not a mandatory prerequisite for developing PH in OSA patients.
    • Lung function and blood gas derangements are key correlates of PH in this population.