Respiratory disturbance during sleep in COPD patients without daytime hypoxemia

Ana C Krieger¹, Nilam Patel², Daniel Green¹, Frank Modersitzki MPH¹, Ilana Belitskaya-Levy³, Angela Lorenzo⁴, Michael Cutaia⁴

¹NYU Sleep Disorders Center, Department of Medicine – Division of Pulmonary and Critical Care Medicine, New York University School of Medicine, New York, NY, USA; ²Division of Pulmonary and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA; ³Division of Biostatistics, Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; ⁴Division of Pulmonary and Critical Care Medicine, VA New York Harbor Healthcare System, Brooklyn, NY, USA

Abstract: Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality. Its possible association with obstructive sleep apnea is a major cause of concern for clinicians. As the prevalence of both COPD and sleep apnea continues to rise, further investigation of this interaction is needed. In addition, COPD patients are at risk for hypoventilation during sleep due to the underlying respiratory dysfunction. In this study, 13 COPD subjects and 13 non-COPD control subjects were compared for the presence and severity of obstructive sleep apnea and nocturnal hypoventilation. All 26 subjects had presented to a sleep clinic and showed no signs of daytime hypoxemia. After matching for BMI and age, COPD subjects had a similar prevalence of sleep apnea with a lower degree of severity compared to the control subjects. However, less severe events, such as RERA, occurred at similar rates between the two groups. There was no significant difference between groups in the magnitude of oxyhemoglobin desaturation during sleep. Interestingly, severity and presence of nocturnal hypoxemia correlated with that of sleep apnea in the control group, but not in the COPD subjects. In conclusion, COPD without daytime hypoxemia was not a risk factor for sleep apnea or nocturnal hypoventilation in this study.

Keywords: sleep apnea, chronic obstructive pulmonary disease, sleep, hypoventilation