Nocturnal hypoxemia in COPD: the amplifying effect of comorbid OSA and PLMS on oxygen desaturation.

IF 3 3区医学 Q2 RESPIRATORY SYSTEM

Therapeutic Advances in Respiratory Disease Pub Date : 2025-01-01 Epub Date: 2025-09-17 DOI:10.1177/17534666251380431

Viraj Jain, Harshill Modi, Moon Park, Anil Ghimire, Lourdes M DelRosso

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引用次数: 0

Abstract

Background: Chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA), and periodic limb movements of sleep (PLMS) frequently co-occur and may exacerbate nocturnal hypoxemia. Still, their combined effects are not well defined.

Objectives: To examine the independent and interactive effects of COPD, OSA, and PLMS on nocturnal oxygen desaturation.

Design: Cross-sectional analysis of a sleep study cohort.

Methods: We analyzed 711 participants (mean age 57.2 ± 17.9 years; 44.4% male), including 48 with COPD. Time with oxygen saturation ⩽88% (ST) and mean SpO₂ were compared across COPD and OSA/PLMS subgroups. Multivariable regression tested the independent and interaction effects of COPD, OSA, PLMS, age, and sex.

Results: Participants with COPD had lower mean SpO₂ and longer ST than non-COPD participants (p < 0.005). ST was greatest in those with both OSA and PLMS, particularly in COPD. COPD (+46.4 min, p < 0.001) and OSA (+10.5 min, p = 0.009) independently increased ST. A negative COPD × OSA interaction (p = 0.021) indicated less-than-additive effects, whereas a positive COPD × OSA × PLMS interaction (p = 0.036) identified the highest desaturation burden.

Conclusion: COPD and OSA independently worsen nocturnal hypoxemia, while the coexistence of COPD, OSA, and PLMS confers the greatest desaturation burden, underscoring the importance of evaluating overlapping conditions in clinical assessment.

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COPD患者夜间低氧血症：OSA和PLMS合并症对氧去饱和的放大作用。

背景：慢性阻塞性肺疾病（COPD）、阻塞性睡眠呼吸暂停（OSA）和周期性睡眠肢体运动（PLMS）经常同时发生，并可能加剧夜间低氧血症。尽管如此，它们的综合效应还没有得到很好的界定。目的：探讨COPD、OSA和PLMS对夜间氧饱和度的独立和相互作用。设计：对睡眠研究队列进行横断面分析。方法：我们分析了711名参与者（平均年龄57.2±17.9岁，男性44.4%），其中48名COPD患者。比较COPD和OSA/PLMS亚组的血氧饱和度≥88% （ST）时间和平均SpO2。多变量回归检验了COPD、OSA、PLMS、年龄和性别的独立效应和交互效应。结果：COPD患者的平均SpO2低于非COPD患者（p = 0.009）， ST更长（p = 0.009）独立增加ST。COPD × OSA相互作用阴性（p = 0.021）表明其加性效应小于加性效应，而COPD × OSA × PLMS相互作用阳性（p = 0.036）表明其去饱和负荷最高。结论：COPD和OSA单独加重夜间低氧血症，而COPD、OSA和PLMS共存造成最大的去饱和负荷，强调在临床评估中评估重叠情况的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Respiratory Disease RESPIRATORY SYSTEM-

CiteScore

6.90

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Respiratory Disease delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of respiratory disease.