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. 2009 Oct 15;180(8):788-93.
doi: 10.1164/rccm.200905-0773OC. Epub 2009 Jul 30.

The impact of obesity on oxygen desaturation during sleep-disordered breathing

Paul E Peppard  1 , Neil R Ward, Mary J Morrell
Affiliations

The impact of obesity on oxygen desaturation during sleep-disordered breathing

Paul E Peppard et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Obesity increases the risk and severity of sleep-disordered breathing. The degree to which excess body weight contributes to blood oxygen desaturation during hypopneic and apneic events has not been comprehensively characterized.

Objectives: To quantify the association between excess body weight and oxygen desaturation during sleep-disordered breathing.

Methods: A total of 750 adult participants in the Wisconsin Sleep Cohort Study were assessed for body mass index (BMI) (kg/m(2)) and sleep-disordered breathing. The amount of Sa(O(2)), duration, and other characteristics of 37,473 observed breathing events were measured during polysomnography studies. A mixed-effects linear regression model estimated the association of blood oxygen desaturation with participant-level characteristics, including BMI, gender, and age, and event-level characteristics, including baseline Sa(O(2)), change in Vt, event duration, sleep state, and body position.

Measurements and main results: BMI was positively associated with oxygen desaturation severity independent of age, gender, sleeping position, baseline Sa(O(2)), and event duration. BMI interacted with sleep state such that BMI predicted greater desaturation in rapid eye movement (REM) sleep than in non-REM sleep. Each increment of 10 kg/m(2) BMI predicted a 1.0% (SE, 0.2%) greater mean blood oxygen desaturation for persons in REM sleep experiencing hypopnea events associated with 80% Vt reductions.

Conclusions: Excess body weight is an important predictor of the severity of blood oxygen desaturation during apnea and hypopnea events, potentially exacerbating the impact of sleep-disordered breathing in obese patients.

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Figures

Figure 1.
Figure 1.
Predicted ΔSaO2 for a hypopnea (100% baseline SaO2, 30 seconds in duration, with an 80% ΔVt, in supine 50-year-old subjects) by body mass index and sleep state in (A) men and (B) women. Error bars indicate upper (REM) and lower (NREM) 95% confidence limit for predicted mean ΔSaO2.
Figure 1.
Figure 1.
Predicted ΔSaO2 for a hypopnea (100% baseline SaO2, 30 seconds in duration, with an 80% ΔVt, in supine 50-year-old subjects) by body mass index and sleep state in (A) men and (B) women. Error bars indicate upper (REM) and lower (NREM) 95% confidence limit for predicted mean ΔSaO2.
Figure 2.
Figure 2.
Predicted ΔSaO2 for a hypopnea (100% baseline SaO2, 30 seconds in duration, with an 80% ΔVt during REM sleep, in supine 50-year-old subjects) by body mass index and sleeping position in women. Error bars indicate upper (supine) and lower (lateral) 95% confidence limit for predicted mean ΔSaO2.
See this image and copyright information in PMC

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