Indian Journal of Sleep Medicine

Register      Login

VOLUME 15 , ISSUE 1 ( January-March, 2020 ) > List of Articles

Original Article

A Study to Evaluate Sleep-disordered Breathing in Patients with Chronic Respiratory Failure

Shibdas Chakrabarti, Debasis Behera, Pankaj Gupta, B Viswesvaran

Keywords : Chronic respiratory failure, Comorbidity, Sleep-disordered breathing, Undiagnosed

Citation Information : Chakrabarti S, Behera D, Gupta P, Viswesvaran B. A Study to Evaluate Sleep-disordered Breathing in Patients with Chronic Respiratory Failure. Indian Sleep Med 2020; 15 (1):1-4.

DOI: 10.5005/jp-journals-10069-0050

License: CC BY-NC 4.0

Published Online: 01-03-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Sleep-disordered breathing (SDB) in patients with chronic respiratory failure (CRF) due to pulmonary disease remains an underrated and undiagnosed entity. Materials and methods: A prospective descriptive study in patients with CRF with history suggestive of SDB was carried out using polysomnography (PSG) over a period of 12 months. Results: Thirty patients with the Epworth sleepiness scale greater than 11 and CRF underwent PSG. Ninety percent patients had obstructive sleep apnea (OSA) syndrome using the respiratory disturbance index (RDI) of 5 as cut-off. Mean RDI was 13.4 and mean apnea-hypopnea Index (AHI) was 10.5. Besides, the patients had a poor sleep quality; sleep efficiency was 69.38 ± 14.44%, sleep onset time was 30.35 ± 24.31 minutes. Wake after sleep onset (WASO) was 107.25 ± 57.71 minutes. Rapid-eye-movement (REM) sleep latency was 126.08 ± 66.61 minutes. N1 was 23.75 ± 14.89, N2 was 45.22 ± 12.69, N3 was 20.02 ± 12.57, and REM sleep period was 11.33 ± 8 minutes. The body mass index (BMI) and Epworth sleepiness score (ESS) had a significant correlation with AHI with p value < 0.005. Conclusion: Sleep-disordered breathing is an important comorbidity in patients with CRF leading to increased morbidity and mortality. A high of suspicion must be kept for the same especially in patients with higher BMI and high ESS. Such patients have a poor quality of sleep besides increased incidence of sleep apnea.


PDF Share
  1. Romem A, Iacono A, McIlmoyle E, et al. Obstructive sleep apnea in patients with end-stage lung disease. J Clin Sleep Med 2013;9(7):687–693. DOI: 10.5664/jcsm.2840.
  2. Lancaster LH, Mason WR, Parnell JA, et al. Obstructive sleep apnea is common in idiopathic pulmonary fibrosis. Chest 2009;136(3):772–778. DOI: 10.1378/chest.08-2776.
  3. Mermigkis C, Bouloukaki I, Schiza SE. Obstructive sleep apnea in patients with interstitial lung diseases: past and future. Sleep Breath 2013;17(4):1127–1128. DOI: 10.1007/s11325-013-0836-1.
  4. Shteinberg M, Weiler-Ravel D, Adir Y. The overlap syndrome: obstructive sleep apnea and chronic obstructive pulmonary disease. Harefuah 2009;148(5):333–336, 348.
  5. Shepard JW, Garrison MW, Grither DA, et al. Relationship of ventricular ectopy to nocturnal oxygen desaturation in patients with chronic obstructive pulmonary disease. Am J Med 1985;78(1):28–34. DOI: 10.1016/0002-9343(85)90457-7.
  6. Chaouat A, Weitzenblum E, Krieger J, et al. Association of chronic obstructive pulmonary disease and sleep apnea syndrome. Am J Respir Crit Care Med 1995;151(1):82–86. DOI: 10.1164/ajrccm.151.1.7812577.
  7. Chaouat A, Weitzenblum E, Krieger J, et al. Pulmonary hemodynamics in the obstructive sleep apnea syndrome. Results in 220 consecutive patients. Chest 1996;109(2):380–386. DOI: 10.1378/chest.109.2.380.
  8. Mansfield D, Naughton MT. Effects of continuous positive airway pressure on lung function in patients with chronic obstructive pulmonary disease and sleep disordered breathing. Respirology 1999;4(4):365–370. DOI: 10.1046/j.1440-1843.1999.00206.x.
  9. de Miguel J, Cabello J, Sánchez-Alarcos JM, et al. Long-term effects of treatment with nasal continuous positive airway pressure on lung function in patients with overlap syndrome. Sleep Breath 2002;6(1):3–10. DOI: 10.1007/s11325-002-0003-6.
  10. Peker Y, Hedner J, Johansson A, et al. Reduced hospitalization with cardiovascular and pulmonary disease in obstructive sleep apnea patients on nasal CPAP treatment. Sleep 1997;20(8):645–653. DOI: 10.1093/sleep/20.8.645.
  11. Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013;177(9):1006–1014. DOI: 10.1093/aje/kws342.
  12. Hornbein TF, Griffo ZJ, Roos A. Quantitation of chemoreceptor activity: interrelation of hypoxia and hypercapnia. J Neurophysiol 1961;24:561–568. DOI: 10.1152/jn.1961.24.6.561.
  13. Agusti A, Hedner J, Marin JM, et al. Night-time symptoms: a forgotten dimension of COPD. Eur Respir Rev 2011;20(121):183–194. DOI: 10.1183/09059180.00004311.
  14. Chakrabarti S, Ish P, Rathi V. Obstructive sleep apnea and chronic obstructive pulmonary disease overlap syndrome - double trouble. J Adv Res Med 2018;5(4):25–30. DOI: 10.24321/2349.7181.201821.
  15. André S, Andreozzi F, Van Overstraeten C, et al. Cardiometabolic comorbidities in obstructive sleep apnea patients are related to disease severity, nocturnal hypoxemia, and decreased sleep quality. Respir Res 2020;21(1):35. DOI: 10.1186/s12931-020-1284-7.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.