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Hypercapnic Obstructive Sleep Apnea : An Underappreciated Marker of Severity

Clifford Zwillich, MD; Carolyn H. Welsh, MD, FCCP
Author and Funding Information

Affiliations: Denver, CO ,  Dr. Zwillich is Staff Physician, Denver Veterans Affairs Medical Center, and Professor of Medicine, University of Colorado at Denver Health Sciences Center, Denver Veterans Affairs Medical Center, Denver, CO. Dr. Welsh is Staff Physician, Denver Veterans Affairs Medical Center, and Professor of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado at Denver Health Sciences Center.

Correspondence to: Clifford Zwillich, MD, Denver Veterans Affairs Medical Center, 1055 Clermont St, Denver, CO 80220; e-mail: Clifford.zwillich@va.gov



Chest. 2007;132(6):1729-1730. doi:10.1378/chest.07-1792
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Hypercapnia during wakefulness is a marker of disease severity in patients with sleep apnea. These patients are often very obese, have long apnea events with marked oxygen desaturation, evidence of pulmonary hypertension, and right-heart failure. Without appropriate treatment, such patients require frequent hospital admission1 and have alarming mortality rates.2 Fortunately, following the successful application of continuous positive airway pressure (CPAP) or bilevel ventilation, daytime hypercapnia often improves3 and recurrent hospital admission rates decrease.1

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