Sleep disturbances (SD) and severe nocturnal hypoxia of unclear etiology have been previously reported in patients with PAH. We performed sleep studies in PAH patients to evaluate their sleep characteristics and to look for possible factors associated with SD or NH.
Patients followed at our PAH center who underwent sleep studies were included in the study. Variables analyzed included: apnea-hypopnea index (AHI), arousal index (AI), sleep stages, limb movements, oximetry, and EKG changes. Patients who spent more than 10% of the total sleep time (TST) with an oxygen saturation (SpO2) <90% were considered nocturnal desaturators (ND) and patients with an arousal index (AI) >10 or sleep efficiency <70% were considered to have SD.
Patients slept an average of 304±66 (mean±SD) min and spent 14±9% (mean±SD) of TST in REM, 9±8 %(mean±SD) in stage 1, 66±18%(mean±SD) in stage 2, and 5±6 % (mean±SD) in SWS. Out of the 20 patients, 12 (60%) were nocturnal desaturators. On average patients spent 22±27% (mean±SD) of their TST <90% SpO2. Five patients spent > 30% of TST <90% SpO2. Of the desaturators 3 patients were found to have OSA. Eight patients received supplemental oxygen during polysomnography. The overall arousal index was 19.5±12.8 (mean±SD), 11 of 15 (73%) had and arousal index >10, the average sleep efficiency was 76±14% (mean±SD). Five patients had premature ventricular contractions. Periodic limb movement index (PLMI) was 24±31.5 (mean±SD) and four patients had a PLM arousal index >10. None had OSA severe enough to be considered a potential cause of their PAH.
Patients with PAH may have poor quality or non-restorative sleep due to a variety of factors including PLMs, and nocturnal desaturation even in the absence of sleep disordered breathing.
Patients with PAH may have poor sleep quality or non-restorative sleep and nocturnal hypoxia even in the absence of sleep-disordered breathing.
Chirag Pandya, None.