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. 2021;60(19):3071-3079.
doi: 10.2169/internalmedicine.6329-20. Epub 2021 Oct 1.

Prospective Study of Nocturnal Desaturation in Patients Receiving Home Oxygen Therapy

Asuka Yoshizaki  1 , Tatsuya Nagano  1 , Shintaro Izumi  2 , Yasuhiro Funada  3 , Kyosuke Nakata  1   4 , Teruaki Nishiuma  5 , Kiyonobu Takatsuki  6 , Hisashi Ohnishi  7 , Nobuko Hazeki  1   7 , Yuichiro Yasuda  1 , Ryota Dokuni  1 , Masatsugu Yamamoto  1 , Kazuyuki Kobayashi  1 , Yoshihiro Nishimura  1
Affiliations

Prospective Study of Nocturnal Desaturation in Patients Receiving Home Oxygen Therapy

Asuka Yoshizaki et al. Intern Med. 2021.

Abstract

Objective Nocturnal desaturation is common in patients with chronic respiratory disease and often worsens the prognosis. Therefore, it should be diagnosed accurately and appropriately treated. The aim of this study was to clarify the diversity of nocturnal desaturation. Methods We prospectively enrolled 58 outpatients diagnosed with chronic respiratory disease receiving home oxygen therapy and measured nocturnal SpO2 using a portable oximeter. We classified nocturnal desaturation (3% decrease in SpO2 from baseline) into three patterns: periodic pattern (desaturation duration of <655 seconds), sustained pattern (desaturation duration of ≥655 seconds), and intermittent pattern (desaturation and recovery of SpO2 repeated with a cycle of several minutes). Results Nocturnal hypoxemia (SpO2≤88% for more than 5 minutes) was found in 23.8% of patients. The percentage of patients with chronic obstructive pulmonary disease (COPD) was significantly higher in the nocturnal hypoxemia group than in the non-hypoxemia group (80% vs. 40.6%, p=0.03). Desaturation with a periodic pattern was found in 81% of patients, desaturation with a sustained pattern was found in 40.5% of patients, and desaturation with an intermittent pattern was found in 59.5% of patients. In patients with COPD, desaturation with a periodic pattern was found in 85.7%, desaturation with a sustained pattern was found in 47.6%, and desaturation with an intermittent pattern was found in 57.1%. Conclusion The SpO2 waveform of nocturnal hypoxemia was able to be classified into three patterns. Suitable treatment for each pattern might improve the prognosis of these patients.

Keywords: COPD; nocturnal desaturation; obstructive sleep apnoea; rapid eye movement.

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Conflict of interest statement

Author's disclosure of potential Conflicts of Interest (COI).

Yoshihiro Nishimura: Research funding, Teijin Pharma.

Figures

Figure 1.
Figure 1.
Flowchart describing patient recruitment.
Figure 2.
Figure 2.
Typical waveforms of the (a) periodic pattern, (b) sustained pattern, and (c) intermittent pattern. The matching rate between classification by an automatic analysis algorithm and by chest physicians for the (d) periodic pattern, (e) sustained pattern, and (f) intermittent pattern.
Figure 3.
Figure 3.
Dot plot of %FEV1 in COPD patients. %FEV1: percent predicted forced expiratory volume in 1 second
Figure 4.
Figure 4.
Dot plot of the indicated parameters in COPD patients. Categories are described in the Patients and Methods. %FEV1: percent predicted forced expiratory volume in 1 second
See this image and copyright information in PMC

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References

    1. Fletcher EC, Miller J, Divine GW, Fletcher JG, Miller T. Nocturnal oxyhemoglobin desaturation in COPD patients with arterial oxygen tensions above 60 mm Hg. Chest 92: 604-608, 1987. - PubMed
    1. Krachman S, Minai OA, Scharf SM. Sleep abnormalities and treatment in emphysema. Proc Am Thorac Soc 5: 536-542, 2008. - PMC - PubMed
    1. Owens RL, Malhotra A. Sleep-disordered breathing and COPD: the overlap syndrome. Respir Care 55: 1333-1344; discussion 1344-1346, 2010. - PMC - PubMed
    1. Douglas NJ, White DP, Pickett CK, Weil JV, Zwillich CW. Respiration during sleep in normal man. Thorax 37: 840-844, 1982. - PMC - PubMed
    1. Carroll N, Walshaw MJ, Evans CC, Hind CR. Nocturnal oxygen desaturation in patients using long-term oxygen therapy for chronic airflow limitation. Respir Med 84: 199-201, 1990. - PubMed