Poster Presentations: Wednesday, October 26, 2011 |

Prevalence of Sleep Associated Alveolar Hypoventilation in a Young Adult Population Presenting for Evaluation of a Sleep Complaint FREE TO VIEW

Richard Bogan, MD; Jo Anne Turner, MN
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SleepMed Inc., Columbia, SC

Chest. 2011;140(4_MeetingAbstracts):806A. doi:10.1378/chest.1112105
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PURPOSE: In subjects less than age 40 presenting for sleep evaluation with PSG, prevalence of sleep induced alveolar hypoventilation with hypoxemia (AH) and obstructive apnea (OSA) are examined, demographics reviewed and degree of sleepiness reported.

METHODS: 42513 baseline PSGs from 2009-2010 at SleepMed were reviewed. ESS was administered prior to study. Two groups of sleep disordered breathing (SDB) were compared: AH group included RDI <10, nadir O2 < 85%, ODI <10 and time below 90% = > 10 minutes. The OSA group included RDI >15 without regard to ODI. Oxygen desaturation index (ODI) was measured at equal to or greater than 4%.

RESULTS: Of 22151 men studied 5723(26%) were younger than age 40. Of the 5723 men, 2066 (36%) were identified to have SDB (AH+OSA=SDB). Of 21362 women studied 5138 (24%) were younger than age 40. Of the 5138 women 1056 (21%) were identified to have SDB. As a group of the 10861 younger than age 40 there were 3122 total (29%) with SDB. AH group accounted for 202/10861 (2%) of the total younger adults studied and 202/3122 SDB (6%). Men (n=89, 44%) with AH ages less than 40 were characterized by a mean age of 25(14); BMI 29(9); ESS 8(7); RDI 6(3); nadir O2 sat 78(12); time<90% minutes 67(82); ODI 4(3). Women (n=113, 56%) with AH ages less than 40 were characterized by a mean age of 29(11); BMI 35(19); ESS 10(6); RDI 5(3); nadir O2 sat 79(7); time<90% minutes 104(112); ODI 4(2). AH/SDB= 4% of men and 11% women. OSA accounted for 2920/10861 (27%) of the total and 2920/3122 SDB (94%) of individuals under the age of 40. Demographics of this group were: mean age of 36(11); BMI 36(11); ESS 10(6); RDI 37 (25); nadir O2 Sat 80(9); ODI 26(24); time<90% minutes 31(52). Men (n=1977, 68%) with OSA were characterized by a mean age of 31(19), BMI 35(9); ESS 10.0(6); RDI 39(26); nadir O2 sat 80(9); time<90% minutes 34(55); ODI 27(25). Women with OSA (n=943, 32%) were characterized by a mean age of 30(9); BMI 41(12); ESS 10.5(6); RDI 33(22); nadir O2 sat 81(9); time<90% minutes 24(45); ODI 22(21). OSA/SDB = 96% in men and 89% in women.

CONCLUSIONS: 29% of younger adults presenting for PSG had clinically relevant SDB. 2% of individuals less than age 40 studied by PSG met criteria for sleep induced hypoxemia. This represented 6% of SDB group. Women had a disproportionately higher prevalence of AH (11% vs 4%), were heavier by BMI, and ESS scores were slightly higher.

CLINICAL IMPLICATIONS: The gender differences suggest the need for further study as to the pathogenesis of sleep hypoventilation and hypoxemia.

DISCLOSURE: Richard Bogan: Shareholder: SleepMed, inc., Consultant fee, speaker bureau, advisory committee, etc.: Speaker Bureau for Jazz, Cephalon, Sunovion , Consultant fee, speaker bureau, advisory committee, etc.: Consultant for Jazz, Cephalon, GSK, UCB, Sunovion, Apnicure

Jo Anne Turner: Consultant fee, speaker bureau, advisory committee, etc.: Speaker Bureau for Cephalon, Sunovion, Pfizer, Somaxson

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