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Sleep Disorders |

Relationship Between the Respiratory Polygraphy Indicators in Patients With Sleep Apneas. Comparison Between Normal-Weight Subjects and Patients With Different Grades of Obesity

Glenda Ernst, PhD; Martín Bosio, MD; Jeronimo Campos, MD; Tamara Decima, MD; Fernando Grassi, MD; Fernando Ditullio, MD; Eduardo Borsini, MD; Felipe Chertcoff, MD; Alejandro Salvado, MD
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British Hospital, Buenos Aires, Argentina


Chest. 2015;148(4_MeetingAbstracts):1050A. doi:10.1378/chest.2251923
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Abstract

SESSION TITLE: Sleep Disorders Posters I: Diagnosis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Obesity is one of the major risk factors predisposing to suffer from obstructive sleep apneas (OSA). The weight gain could be associated with severity of OSA; however the traditional indicators such as apneas/hiponeas index (AHI); oxygen desaturation index (ODI) and time with saturation less than 90% (T90) have variable utility in patients with morbid obesity. To understand the performance of RP indicators in OSA patients with different grades of obesity, we compared the relationship between AHI, ODI and T90.

METHODS: We conducted a retrospective analysis of 648 records from consecutive patients referred to a RP at home, that showed IAH>5 ev/hour. Patients were classified by their body mass index (BMI). The differences and ratio between AHI, ODI and T90 were studied.

RESULTS: We included 57 patients with normal weight, 177 with overweight, 188 y 87 with obesity grade I and grade II respectively; and 139 patients with morbid obesity. Even though, the most of the apneas showed an obstructive profile, obese patients presented a significant increase of the hypopneas. We found concordance between AHI and ODI in patients with normal weight. Difference between both indicators was -0.10±0.55; however this value was reduced when the BMI was increased: -0.82±0.42; p>0.05 in patients with overweight and -2.01±0.52; p<0.001 in obese patients (BMI between 30 and 35); -3.86±0.61; p<0.001 (BMI between 35 and 40) and finally -5.73±0.69; p<0.001 in obsesses with BMI higher than 40. Similar findings were observed between AHI and T90: 7.98±2.18; 6.08±1.42; 1.28±1.89; 1.25±2.62 and -2.45±2.24 respectively (p<0.001).

CONCLUSIONS: Our findings demonstrated that patients with normal weight showed concordance between AHI and ODI or T90, while this concordance was gradually reducing when the BMI was increasing.

CLINICAL IMPLICATIONS: We observed difficulties to evaluate the severity of OSA in patients with different grades of obesity. The increase in the nocturnal desaturation from patients with obesity required the analysis of relationship between IAH and ODI or IAH and T90 to understand better the sleep disorders.

DISCLOSURE: The following authors have nothing to disclose: Glenda Ernst, Martín Bosio, Jeronimo Campos, Tamara Decima, Fernando Grassi, Fernando Ditullio, Eduardo Borsini, Felipe Chertcoff, Alejandro Salvado

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