TITLE:
A study on sleep architecture in patients with chronic respiratory failure under long-term oxygen therapy—Focused on the influence of ventilatory failure (high CO2) elements on the patient’s sleep architecture
AUTHORS:
Tsuguo Nishijima, Keisuke Hosokawa, Fumitaka Mito, Tetsuya Kizawa, Susumu Takahashi, Hiroshi Kagami, Akira Suwabe, Shigeru Sakurai
KEYWORDS:
Chronic Respiratory Failure; Long-Term Oxygen Therapy; Sleep Architecture; Periodic Leg Movement Disorder
JOURNAL NAME:
Health,
Vol.5 No.8B,
August
12,
2013
ABSTRACT: Sleep disturbance
related symptoms are common in patients with long-term oxygen therapy (LTOT).
Essentially, there were only few previous reports about the sleep architecture
in patients with respiratory disease, such as chronic obstructive pulmonary disease (COPD). This study aims to
clarify the objective sleep state and the elements that affect sleep
architecture in Chronic Respiratory Failure (CRF) patients with focus on
clinical cases of chronic hypercapnia. 13 subjects with chronic respiratory
failure were enrolled in the study. All the subjects were pre-evaluated by
pulmonary function test and Arterial blood gas analysis (ABG) including exercise
testing. Polysomnography (PSG) test was performed in each subject with
supplemental oxygen. The estimated base line PaCO2 value that
reflects overall PaCO2 including sleep period was calculated using
equation of PaCO2[2.4×(HCOˉ3)-22]from obtained ABG value just before PSG test.
6 subjects were classified as hypercapnic
group (base line PaCO2 ≥ 45 mmHg) and 7 subjects were non-hypercapnic
group (base line PaCO2 2 were no significant difference. This study
suggests that patients with estimated hypercapnia had more disturbed sleep
architecture especially significant loss of sleep latency than non-hypercapnic
patient with chronic respiratory failure under LTOT. Nocturnal PaCO2 level or ventilatory function may contribute to sleep disturbance in patients
with estimated hypercapnia during LTOT.