Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 8 , ISSUE 2 ( July-December, 2019 ) > List of Articles

Original Article

Study of Nocturnal Oxygen Desaturation in Chronic Obstructive Pulmonary Disease Patients

Naveen Kuzhikkattil, Kamal Nayan Shringi, Babulal Bansiwal, Anil Saxena, Suman Khangarot, Shinu A. Wahab

Keywords : Chronic obstructive pulmonary diseases, nocturnal oxygen desaturation, overlap syndrome, respiratory disturbance index

Citation Information : Kuzhikkattil N, Shringi KN, Bansiwal B, Saxena A, Khangarot S, Wahab SA. Study of Nocturnal Oxygen Desaturation in Chronic Obstructive Pulmonary Disease Patients. Indian J Respir Care 2019; 8 (2):87-91.

DOI: 10.4103/ijrc.ijrc_6_19

License: CC BY-NC-SA 4.0

Published Online: 05-12-2022

Copyright Statement:  Copyright © 2019; Indian Journal of Respiratory Care.


Background: Abnormal sleep architecture with decreased rapid eye movement sleep and arousals during the periods of nocturnal oxygen desaturation (NOD) are seen in patients with chronic obstructive pulmonary disease (COPD) with significant consequences. This study was done to evaluate the prevalence of NOD and other sleep-related disorders in COPD patients. Patients and Methods: This prospective cross-sectional study was conducted in the sleep laboratory of our tertiary center over 1 year. Fifty COPD patients were enrolled in this study. They were classified into mild COPD and moderate COPD, according to the Global Initiative for Obstructive Lung Disease (GOLD) classification. Complete history, physical examination, and relevant laboratory investigations were taken. All patients were subjected to overnight polysomnography. Results: Eight patients had mild COPD, whereas 42 patients had moderate COPD. Mean sleep efficiency was decreased with an average of 71.08% with a significant difference between mild and moderate COPD cases. Minimal SpO2, average SpO2, SpO2 <90%, and duration of SpO2 <90% in the study group showed mean values of 80.77%, 94.33%, 3.93%, and 12.09 min, respectively, with a mean respiratory disturbance index (RDI) of 2.45. NOD was seen in 18% (9 patients) and overlap syndrome was seen in 12% (6 patients) in our study. Forced expiratory volume in 1 s and SpO2 were found to have statistically significant difference (P < 0.05) between patients with respect to NOD. It correlated well with body mass index (BMI) and neck circumference with RDI and also overlap syndrome. Conclusions: NOD is related to the degree of respiratory dysfunction and can coexist with overlap syndrome. Occurrence of overlap syndrome can be predicted with the help of BMI and RDI.

  1. Carskadon MA, Rechtschaffen A. Monitoring and staging human sleep. Princ Pract Sleep Med 2000;3:1197-215.
  2. Gerald LB, Bailey WC. Global initiative for obstructive lung disease. J Cardiopulm Rehabil Prev 2002;22:234-44.
  3. McNicholas WT. Impact of sleep in COPD. Chest 2000;117:48S-53S.
  4. Mulloy E, McNicholas WT. Ventilation and gas exchange during sleep and exercise in severe COPD. Chest 1996;109:387-94.
  5. Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, Vela-Bueno A, et al. Prevalence of sleep-disordered breathing in women: Effects of gender. Am J Respir Crit Care Med 2001;163:608-13.
  6. Soler X, Gaio E, Powell FL, Ramsdell JW, Loredo JS, Malhotra A, et al. High prevalence of obstructive sleep apnea in patients with moderate to severe chronic obstructive pulmonary disease. Ann Am Thorac Soc 2015;12:1219-25.
  7. Radwan L, Maszczyk Z, Koziorowski A, Koziej M, Cieslicki J, Sliwinski P, et al. Control of breathing in obstructive sleep apnoea and in patients with the overlap syndrome. Eur Respir J 1995;8:542-5.
  8. Papachatzakis I, Velentza L, Zarogoulidis P, Kallianos A, Trakada G. Comorbidities in coexisting chronic obstructive pulmonary disease and obstructive sleep apnea - Overlap syndrome. Eur Rev Med Pharmacol Sci 2018;22:4325-31.
  9. Steveling EH, Clarenbach CF, Miedinger D, Enz C, Dürr S, Maier S, et al. Predictors of the overlap syndrome and its association with comorbidities in patients with chronic obstructive pulmonary disease. Respiration 2014;88:451-7.
  10. Bednarek M, Plywaczewski R, Jonczak L, Zielinski J. There is no relationship between chronic obstructive pulmonary disease and obstructive sleep apnea syndrome: A population study. Respiration 2005;72:142-9.
  11. Lewis CA, Fergusson W, Eaton T, Zeng I, Kolbe J. Isolated nocturnal desaturation in COPD: Prevalence and impact on quality of life and sleep. Thorax 2009;64:133-8.
  12. Lacasse Y, Sériès F, Vujovic-Zotovic N, Goldstein R, Bourbeau J, Lecours R, et al. Evaluating nocturnal oxygen desaturation in COPD - Revised. Respir Med 2011;105:1331-7.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.