Poster Presentations: Wednesday, November 3, 2010 |

Identifying High Risk of Sleep-Disordered Breathing in Patients With Idiopathic Pulmonary Fibrosis FREE TO VIEW

Aynur Okcay, MD; James P. Utz, MD; Michael J. Krowka, MD
Author and Funding Information

Mayo Clinic, Rochester, MN

Chest. 2010;138(4_MeetingAbstracts):530A. doi:10.1378/chest.10539
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PURPOSE: Sleep Disordered Breathing (SDB) has been found in patients with Idiopathic Pulmonary Fibrosis (IPF) utilizing polysomnography (PSG). Overnight oximetry (ov/ox) is an effective tool to screen for abnormal nocturnal oxygenation. Retrospectively, we sought to determine the frequency and characteristics of abnormal ov/ox in the largest IPF cohort studied to date.

METHODS: From January '02 to December '06, we analyzed ov/ox from 268 IPF patients (ATS criteria). None used CPAP, BIPAP or supplemental oxygen during sleep. Abnormal ov/ox was defined as follows: O2 saturation < 90% occurred more than 10% of monitoring time (desaturators); or oxygen desaturation index (ODI - number of times ≥ 4% drop in O2 saturation occurred per hour) greater or equal to 5/hr. Data are presented with mean ± SD and statistical significance considered if p ≤ 0.05.

RESULTS: Mean age was 68 ± 13; 62% were men and BMI was 30 ± 6. Desaturators (53% of total patients) were significantly different from nondesaturators for age (70 ± 11 vs 66 ± 14, p= 0.01), male gender (59% vs 41%, p= 0.02), BMI (31 ± 7 vs 28 ± 5, p= 0.0001), RVSP (45 ± 15 vs 40 ± 12, p= 0.003), abnormal RV function (72% vs 28%, p= 0.04), peak tricuspid regurgitation (3.02 ± 0.5 vs 2.7 ± 0.4 p= 0.0008), DLCO adjusted by Hgb (47 ± 15 vs 52 ± 15, p= 0.01) and exercise desaturations (88 ± 4 vs 92 ± 5, p= 0.0001), ODI 4% ≥ 5 (63% of total patients) was significantly associated with increased age, male gender and increased BMI. FVC was not significantly different by any measure of abnormal ov/ox.

CONCLUSION: Abnormal nocturnal oxygen desaturation (53%) and ODI 4% ≥ 5 (63%) were frequent in IPF patients. Older, obese males, increased RVSP and reduced DLCO were noted more frequently in desaturators.

CLINICAL IMPLICATIONS: Identifying IPF patients with abnormal ox/ov suggests the need for PSG to characterize the extent and clinical implications of SDB.

DISCLOSURE: Aynur Okcay, No Financial Disclosure Information; No Product/Research Disclosure Information

12:45 PM - 2:00 PM




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