TY - JOUR
T1 - Physiologic correlates of sleep quality in severe emphysema
AU - Krachman, Samuel L.
AU - Chatila, Wissam
AU - Martin, Ubaldo J.
AU - Permut, Irene
AU - D'Alonzo, Gilbert E.
AU - Gaughan, John P.
AU - Sternberg, Alice L.
AU - Ciccolella, David
AU - Criner, Gerard J.
N1 - Funding Information:
Special thanks to Anne Marie Kuzma, RN and Gwendolyn Vance, RN for their help on this project. Sources of Support: National Emphysema Treatment Trial Research Group, funding in part by: NHLBI contract no. 1-76116, Centers for Medicare and Medicaid Services, and the Agency for Healthcare Research and Quality.
PY - 2011/6
Y1 - 2011/6
N2 - Background: Sleep quality is poor in severe emphysema. We hypothesized that in addition to nocturnal oxygen desaturation, the severity of airflow obstruction and degree of thoracic hyperinflation are responsible. Methods: Twenty-five patients (14 males, 64 ± 6 [ ± SD] yrs, BMI 24.7 ± 4.2 kg/m2) with severe emphysema (FEV1 = 28 ± 8% predicted, TLC = 125 ± 14% predicted) were studied. Measurements included spirometry, lung volumes, arterial blood gas, length of the diaphragm's zone of apposition (LZAP) and a polysomnogram. Results: Total sleep time (TST) was 227 ± 93 minutes with a sleep efficiency (SE) of 56 ± 21%. The mean SaO2, lowest SaO2, and% TST with a SaO2 < 90% were 90 ± 5%, 83 ± 8% and 29 ± 40%, respectively. TST correlated with FEV1% (r = 0.5, p = 0.02), FVC% (r = 0.4, p = 0.03) and LZAP (r = 0.5, p = 0.01). SE correlated with FEV1% (r = 0.5, p = 0.02) and LZAP (r = 0.5, p = 0.01), but not with FVC% (r = 0.4, p = 0.07). Additionally, TST and SE correlated negatively with residual volume% (r = -0.4, p = 0.046, and r = -0.4, p = 0.03, respectively). There was no correlation between TST and SE and measures of nocturnal oxygenation. Multiple linear regression was used to predict TST, with 50% (r2 = 0.49) explained by a combination of LZAP (27%), mean SaO2 (23%), and the lowest SaO2 (< 1%). To predict SE, 44% (r2 = 0.43) was explained by a combination of LZAP (29%), mean SaO2 (14%), and the lowest SaO2 (1%). Conclusion: Although parameters of respiratory function and mechanics correlate with sleep quality, both nocturnal oxygenation and measurements of respiratory function/mechanics predict sleep quality in severe emphysema.
AB - Background: Sleep quality is poor in severe emphysema. We hypothesized that in addition to nocturnal oxygen desaturation, the severity of airflow obstruction and degree of thoracic hyperinflation are responsible. Methods: Twenty-five patients (14 males, 64 ± 6 [ ± SD] yrs, BMI 24.7 ± 4.2 kg/m2) with severe emphysema (FEV1 = 28 ± 8% predicted, TLC = 125 ± 14% predicted) were studied. Measurements included spirometry, lung volumes, arterial blood gas, length of the diaphragm's zone of apposition (LZAP) and a polysomnogram. Results: Total sleep time (TST) was 227 ± 93 minutes with a sleep efficiency (SE) of 56 ± 21%. The mean SaO2, lowest SaO2, and% TST with a SaO2 < 90% were 90 ± 5%, 83 ± 8% and 29 ± 40%, respectively. TST correlated with FEV1% (r = 0.5, p = 0.02), FVC% (r = 0.4, p = 0.03) and LZAP (r = 0.5, p = 0.01). SE correlated with FEV1% (r = 0.5, p = 0.02) and LZAP (r = 0.5, p = 0.01), but not with FVC% (r = 0.4, p = 0.07). Additionally, TST and SE correlated negatively with residual volume% (r = -0.4, p = 0.046, and r = -0.4, p = 0.03, respectively). There was no correlation between TST and SE and measures of nocturnal oxygenation. Multiple linear regression was used to predict TST, with 50% (r2 = 0.49) explained by a combination of LZAP (27%), mean SaO2 (23%), and the lowest SaO2 (< 1%). To predict SE, 44% (r2 = 0.43) was explained by a combination of LZAP (29%), mean SaO2 (14%), and the lowest SaO2 (1%). Conclusion: Although parameters of respiratory function and mechanics correlate with sleep quality, both nocturnal oxygenation and measurements of respiratory function/mechanics predict sleep quality in severe emphysema.
KW - COPD
KW - Emphysema
KW - Nocturnal Oxygenation
KW - Sleep Efficiency
KW - Sleep Quality
KW - Total Sleep Time
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U2 - 10.3109/15412555.2011.560583
DO - 10.3109/15412555.2011.560583
M3 - Article
C2 - 21513441
AN - SCOPUS:79957589600
SN - 1541-2555
VL - 8
SP - 182
EP - 188
JO - COPD: Journal of Chronic Obstructive Pulmonary Disease
JF - COPD: Journal of Chronic Obstructive Pulmonary Disease
IS - 3
ER -