Purpose

The impact of obstructive sleep apnea syndrome (OSAS) in terms of mortality, morbidity, and quality of life has been well established. Phenotyping OSAS is essential in order to make the best therapeutic choice. A particular subset of patients with OSAS shows nocturnal respiratory failure, defined by a nighttime oxygen saturation <90% in more than 30% of the total sleep time (TST90). The aim of this study was to identify possible predictive factors for nighttime respiratory failure (NRF) in patients with OSAS.

Methods

In this retrospective study, patients with suspected OSAS who underwent a sleep study were enrolled. Of 116 patients with moderate/severe OSAS who met the inclusion criteria, 67 also had nocturnal respiratory failure. We compared clinical, anthropometric, and laboratory data in patients with OSAS vs. OSAS and nocturnal respiratory failure.

Results

Patients with OSAS and nocturnal respiratory failure were more frequently female, had a higher BMI, lower daytime oxygen partial pressure (PaO2) in arterial blood, higher Apnea Hypopnea Index (AHI), and a lower number of sleep hours per night. Chronic obstructive pulmonary disease (COPD) was more diagnosed in the group of patients with nocturnal respiratory failure. A lower number of total sleep hours, lower daytime PaO2, lower AHI, increased oxygen desaturation index (ODI), and the presence of a diagnosed COPD were all found to increase the risk of having nocturnal respiratory failure.

Conclusion

COPD, AHI, ODI, daytime PaO2, and total sleep hours are the main predictors for NRF in patients with moderate and severe OSAS.

中文翻译：

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中度和重度 OSAS 患者夜间呼吸衰竭的预测工具

目的

阻塞性睡眠呼吸暂停综合征 (OSAS) 在死亡率、发病率和生活质量方面的影响已得到充分证实。为了做出最佳治疗选择，对 OSAS 进行表型分析至关重要。OSAS 患者的一个特定子集显示夜间呼吸衰竭，其定义为夜间氧饱和度 <90%，且总睡眠时间超过 30% (TST90)。本研究的目的是确定 OSAS 患者夜间呼吸衰竭 (NRF) 的可能预测因素。

方法

在这项回顾性研究中，纳入了接受过睡眠研究的疑似 OSAS 患者。在符合纳入标准的 116 名中度/重度 OSAS 患者中，67 名患者还患有夜间呼吸衰竭。我们比较了 OSAS 患者与 OSAS 患者和夜间呼吸衰竭患者的临床、人体测量和实验室数据。

结果

患有 OSAS 和夜间呼吸衰竭的患者更常见于女性，她们的 BMI 更高，动脉血白天氧分压 (PaO2) 更低，呼吸暂停低通气指数 (AHI) 更高，每晚睡眠时间更少。慢性阻塞性肺病 (COPD) 在夜间呼吸衰竭患者组中的诊断率更高。较少的总睡眠时间、较低的白天 PaO2、较低的 AHI、较高的氧饱和度指数 (ODI) 以及诊断为 COPD 的存在都被发现会增加夜间呼吸衰竭的风险。

结论

COPD、AHI、ODI、日间 PaO2 和总睡眠时间是中度和重度 OSAS 患者 NRF 的主要预测因子。