Obesity hypoventilation syndrome: prevalence and predictors in patients with obstructive sleep apnea

Mokhlesi, Babak; Tulaimat, Aiman

doi:10.1007/s11325-007-0122-1

Cited by 44 publications

(91 citation statements)

References 10 publications

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“…In our study, OHS prevalence was 42.1% in OSA subjects with class II and III obesity, which is higher than in previous studies. 2,[8][9][10][11][12][13][14][22][23][24][25] The mean BMI of our subjects was higher than in most previous studies. [9][10][11][12]14,[23][24][25] This might be the reason for our higher rate.…”

Section: Discussioncontrasting

confidence: 51%

“…OHS prevalence in patients with OSA varies from 11 to 38%. 2,[7][8][9][10][11][12][13][14][22][23][24][25] The prevalence increases with obesity severity. In our study, OHS prevalence was 42.1% in OSA subjects with class II and III obesity, which is higher than in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…However, the frequency of OHS in our study was also higher than in previous studies with a mean BMI of Ͼ 40 kg/m 2 . 2,8,13,22 The largest OHS study in the literature was retrospective, and the prevalence of OHS was 11%. 12 In that study, the prevalence was 24% in 12 There are few prospective studies, and OHS prevalence in these studies is between 13% and 37%.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Patients with OHS have higher morbidity, lower quality of life, more healthcare expenses, greater risk of pulmonary hypertension, and higher mortality compared with eucapnic obese patients with or without obstructive sleep apnea (OSA). [3][4][5][6] Diagnosis of OHS requires arterial blood gas (ABG) analysis, but ABG analysis is not routinely performed in sleep laboratories due to its invasive nature.…”

Section: Introductionmentioning

confidence: 99%

“…Daytime hypercapnia in patients with OSA has been reported at 10 -38%, and prevalence increases with rising body mass index (BMI). 2,[7][8][9][10][11][12][13][14] Most patients with OHS have coexisting OSA. 15 As patients with OHS have a worse prognosis than patients with pure OSA and use more health-care resources, understanding the clinical characteristics of OHS is important.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Predictors of Obesity Hypoventilation Syndrome in Obese Subjects With Obstructive Sleep Apnea

Bingöl¹,

Pıhtılı

Çağatay

et al. 2015

Respir Care

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BACKGROUND: Arterial blood gas (ABG) analysis is not a routine test in sleep laboratories due to its invasive nature. Therefore, the diagnosis of obesity hypoventilation syndrome (OHS) is underestimated. We aimed to evaluate the differences in subjects with OHS and pure obstructive sleep apnea (OSA) and to determine clinical predictors of OHS in obese subjects. METHODS: Demographics, body mass index (BMI), Epworth Sleepiness Scale score, polysomnographic data, ABG, spirometric measurements, and serum bicarbonate levels were recorded. RESULTS: Of 152 obese subjects with OSA (79 females/73 males, mean age of 50.3 ؎ 10.6 y, BMI of 40.1 ؎ 5.6 kg/m 2 , 51.9% with severe OSA), 42.1% (n ‫؍‬ 64) had OHS. Subjects with OHS had higher BMI (P ‫؍‬ .02), neck circumference (P < .001), waist circumference (P < .001), waist/hip ratio (P ‫؍‬ .02), Epworth Sleepiness Scale scores (P ‫؍‬ .036), ABG and serum bicarbonate levels (P < .001), apnea-hypopnea index (P ‫؍‬ .01), oxygen desaturation index (P < .001), and total sleep time with S pO 2 < 90% (P < .001) compared with subjects with pure OSA (n ‫؍‬ 88). They also had lower daytime P aO 2 (P < .001), sleep efficiency (P ‫؍‬ .032), mean S pO 2 (P < .001), and nadir S pO 2 (P < .001) . Serum bicarbonate levels and nadir S pO 2 were the only independent predictive factors for OHS. A serum bicarbonate level of > 27 mmol/L as the cutoff gives a satisfactory discrimination for the diagnosis of OHS (sensitivity of 76.6%, specificity of 74.6%, positive predictive value of 54.5%, negative predictive value of 88.9%). A nadir S pO 2 of < 80% as the cutoff gives a satisfactory discrimination for the diagnosis of OHS (sensitivity of 82.8%, specificity of 54.5%, positive predictive value of 56.9%, negative predictive value of 81.4%). When we used a serum bicarbonate level of > 27 mmol/L and/or a nadir S pO 2 of < 80% as a screening measure, only 3 of 64 subjects with OHS were missed. CONCLUSIONS: Serum bicarbonate level and nadir saturation were independent predictive factors for the diagnosis of OHS.

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