Esen KIYAN, Aylin PIHTILI, Züleyha BİNGÖL

The Predictors of Obesity Hypoventilation Syndrome in Obstructive Sleep Apnea

Background: As obesity increases, the frequency ofobstructive sleep apnea and obesity hypoventilationsyndrome increases also. However, obesityhypoventilation syndrome frequency is not known,as capnography and arterial blood gas analysis are notroutinely performed in sleep laboratories.Aims: To investigate the frequency and predictors ofobesity hypoventilation syndrome in obese subjects.Study Design: Retrospective clinical studyMethods: Obese subjects who had arterial bloodgas analysis admitted to the sleep laboratory andpolysomnography were retrospectively analyzed.Subjects with restrictive (except obesity) and obstructivepulmonary pathologies were excluded. Demographics,Epworth-Sleepiness-Scale scores, polysomnographicdata, arterial blood gas analysis, and spirometricmeasurements were recorded.Results: Of the 419 subjects, 45.1% had obesityhypoventilation syndrome. Apnea hypopnea index(p

PDF

___

1. Mokhlesi B, Tulaimat A. Recent advances in obesity hypoventilation syndrome. Chest 2007;132:1322-36.
2. International Classification of Sleep Disorders, American Academy of Sleep Medicine, Darien, IL 2014.
3. Nowbar S, Burkart KM, Gonzales R, Fedorowicz A, Gozansky WS, Gaudio JC, et al. Obesity-associated hypoventilation in hospitalized patients: prevalence, effects, and outcome. Am J Med 2004;116:1-7.
4. Akinnusi ME, Saliba R, Porhomayon J, EL-Solh AA. Sleep disorders in morbid obesity. Eur J Intern Med 2012;23:219-26.
5. Ryan S, Crinion SJ, McNicholas WT. Obesity and sleep disordered breathing when to 'bad guys' meet. QJM 2014;107:949-54.
6. Olson AL, Zwillich C. The obesity hypoventilation syndrome. Am J Med 2005;118:948-56.
7. Kessler R, Chaouat A, Schinkewitch P, Faller M, Casel S, Krieger J, et al. The obesity-hypoventilation syndrome revisited: a prospective study of 34 consecutive cases. Chest 2001;120:369-76.
8. Mokhlesi B, Tulaimat A, Faibussowitsch I, Wang Y, Evans AT. Obesity hypoventilation syndrome: prevalence and predictors in patients with obstructive sleep apnea. Sleep Breath 2007;11:117-24.
9. Vgontzas AN, Tan TL, Bixler EO, Martin LF, Shubert D, Kales A. Sleep apnea and sleep disruption in obese patients. Arch Intern Med 1994;154:1705-11.
10. Verin E, Tardif C, Pasquis P. Prevalence of daytime hypercapnia or hypoxia in patients with OSAS and normal lung function. Respir Med 2001;95:693- 6.
11. Laaban JP, Chailleux E. Daytime hypercapnia in adult patients with obstructive sleep apnea syndrome in France, before initiating nocturnal nasal continuous positive airway pressure therapy. Chest 2005;127:710- 5.
12. Resta O, Foschino Barbaro MP, Bonfitto P, Talamo S, Mastrosimone V, Stefano A, et al. Hypercapnia in obstructive sleep apnoea syndrome. Neth J Med 2000;56:215-22.
13. Golpe R, Jimenez A, Carpizo R. Diurnal hypercapnia in patients with obstructive sleep apnea syndrome. Chest 2002;122:1100-1.
14. Akashiba T, Kawahara S, Kosaka N, Ito D, Saito O, Majima T, et al. Determinants of chronic hypercapnia in Japanese men with obstructive sleep apnea syndrome. Chest 2002;121:415-21.
15. Hida W. Quality of life in obesity hypoventilation syndrome. Sleep Breath 2003;7:1-2.
16. Berg G, Delaive K, Manfreda J, Walld R, Kryger MH. The use of healthcare resources in obesity-hypoventilation syndrome. Chest 2001;120:377- 83.
17. Akashiba T, Akahoshi T, Kawahara S, Uematsu A, Katsura K, Sakurai S, et al. Clinical characteristics of obesity-hypoventilation syndrome in Japan: a multi-center study. Intern Med 2006;45:1121-5.
18. Kessler R, Chaouat A, Weitzenblum E, Oswald M, Ehrhart M, Apprill M, et al. Pulmonary hypertension in the obstructive sleep apnea syndrome: prevalence, causes and therapeutic consequences. Eur Respir J 1996;9:787- 94.
19. Polysomnography Taske Force, American Sleep Disorders Association Standards of Practice Committee. Practice parameters for the indications for polysomnography and related procedures. Sleep 1997;20:406-22.
20. Iber C, Ancoli-Israel S, Stuart Quan M. The American Academy of Sleep Medicine manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. Westchester, IL, 2007.
21. Izci B, Ardic S, Firat H, Sahin A, Altinors M, Karacan I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath 2008;12:161-8.
22. Leech JA, Onal E, Baer P, Lopata M. Determinants of hypercapnia in occlusive sleep apnea syndrome. Chest 1987;92:807-13.
23. Atwood CW Jr, McCrory D, Garcia JG, Abman SH, Aheam GS. American College of Chest Physicians. Pulmonary artery hypertension and sleepdisordered breathing: ACCP evidence-based clinical practice guidelines. Chest 2004;126:72-7.
24. Sugerman HJ, Baron PL, Fairman RP, Evans CR, Vetrovec GW. Hemodynamic dysfunction in obesity hypoventilation syndrome and the effects of treatment with surgically induced weight loss. Ann Surg 1988;207:604-13.
25. Mokhlesi B, Tulaimat A, Evans AT, Wang Y, Itani AA, Hassaballa HA, et al. Impact of adherence with positive airway pressure therapy on hypercapnia in obstructive sleep apnea. J Clin Sleep Med 2006;2:57-62.
26. Kauppert CA, Dvorak I, Kollert F, Heinemann F, Jörres RA, Pfeifer M, et al. Pulmonary hypertension in obesity hypoventilation syndrome. Respir Med 2013;107:2061-70.
27. Basoglu OK, Tasbakan MS. Comparison of Clinical Characteristics in Patients with Obesity Hypoventilation Syndrome and Obese Obstructive Sleep Apnea Syndrome: A Case-Control Study. Clin Respir J 2014;8:167-74.
28. Macavei VM, Spurling KJ, Loft J, Makker HK. Diagnostic predictors of obesity-hypoventilation syndrome in patients suspected of having sleep disordered breathing. J Clin Sleep Med 2013;9:879-84.
29. Masa JF, Celli BR, Riesco JA, Hernandz M, Sanchez De Cos J, Disdier C. The obesity hypoventilation syndrome can be treated with noninvasive mechanical ventilation. Chest 2001;119:1102-7.