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Oxygen desaturations during exercise and sleep in fit tetraplegic patients
B Klefbeck1, E Mattsson, J Weinberg
1Karolinska Institute, the Department of Physical Therapy, Huddinge, Sweden.
Objective:
Tetraplegic patients are particularly at risk for respiratory deficiencies during sleep. In a previous study, it was found that several patients exhibited significant oxygen desaturations during arm ergometry tests. Therefore, the issue of whether patients who desaturate during exercise would be especially at risk for having nocturnal respiratory problems was raised.
Design:
Respiratory recordings in connection with arm ergometry tests and during sleep.
Setting:
Arm ergometry tests were performed in a hospital laboratory, and sleep recordings were performed in the patients' homes.
Patients:
Nine C5-C6 tetraplegic patients, aged 22 to 42 years with body mass index of 15.2 to 24.2 kg/m2.
Main Outcome Measures:
Oximetry during exercise and sleep and sleep recordings.
Results:
During exercise, six patients desaturated 6% to 20%. Only one patient had signs of a significant nocturnal respiratory problem with an average of eight desaturations per hour of sleep and an obstructive respiration movement pattern. Two additional patients (with normal oximetry during exercise) showed occasional desaturation below 89% during rapid eye movement sleep.
Conclusion:
In this study, the majority of tetraplegic patients desaturated during submaximal arm exercise but not during sleep. The reason could be that the patients in this study were all lean and physically active, which is at variance with previously published sleep studies.