Predictors Of Obesity Hypoventilation Syndrome Research Articles

Elucidating Predictors of Obesity Hypoventilation Syndrome in a Large Bariatric Surgery Cohort.

Rationale: Although understanding predictors of obesity hypoventilation syndrome (OHS), a condition associated with increased morbidity and mortality, is of key importance for risk prediction, existing characterization is limited.Objectives: We hypothesize that OHS patients referred for bariatric surgery have more severe obstructive sleep apnea and metabolic derangements compared with their eucapnic counterparts.Methods: A total of 1,718 patients undergoing polysomnography with end-tidal CO2 monitoring prior to bariatric surgery at Cleveland Clinic from September 2011 to September 2018 were included. OHS was defined by body mass index (BMI) ≥ 30 kg/m2 and either polysomnography-based end-tidal CO2 ≥ 45 mm Hg or serum bicarbonate levels ≥ 27 mEq/L based on the updated European Respiratory Society guidelines. Unadjusted and multivariable logistic regression models (odds ratio; 95% confidence interval) were used to examine OHS predictors consisting of factors in domains of patient characteristics, polysomnography (cardiorespiratory and sleep architecture), laboratory, and metabolic parameters.Results: The analytic sample comprised 1,718 patients with the following characteristics: age of 45.3 ± 12.1 years, 20.7% were male, BMI = 48.6 ± 9 kg/m2, and 63.6% were white individuals. OHS prevalence was 68.4%. Unadjusted analyses revealed a 1.5% increased odds of OHS (1.01; 1.00-1.03) per 1-unit BMI increase, 1.7% (1.02; 1.01-1.02) per 1% increase in sleep time SaO2 < 90%, 12% increase (1.12; 1.03-1.22) per 1-U increase in hemoglobin A1c, and 3.4% increased odds (1.03; 1.02-1.05) per 5-U increase in apnea-hypopnea index. The association of apnea-hypopnea index with OHS persisted after adjustment for age, sex, race, and BMI and its comorbidities (1.02; 1.01-1.04).Conclusions: OHS was highly prevalent in patients referred for bariatric surgery by more than two-thirds. Even after consideration of confounders including obesity, obstructive sleep apnea remained a strong OHS predictor, as were increasing age, male sex, nocturnal hypoxia, and impaired long-term glucose control. These findings can inform OHS risk stratification in bariatric surgery and set the stage for experimental studies to examine sleep-related respiratory and metabolic contributions to hypoventilation.

A cross sectional study on the predictors of obesity hypoventilation syndrome among patients with obstructive sleep apnea seen at the lung center of the Philippines

A cross sectional study on the predictors of obesity hypoventilation syndrome among patients with obstructive sleep apnea seen at the lung center of the Philippines

Predictors of obesity hypoventilation syndrome among patients with sleep-disordered breathing in India.

Introduction:No study has been done in India to evaluate obesity hypoventilation syndrome (OHS) among patients with sleep-disordered breathing (SDB). The known predictors of OHS, i.e., body mass index (BMI) >35 kg/m2 and forced vital capacity (FVC) <3.5 L for men and <2.3 L for women from western countries, cannot be applied to Indian patients.Objectives:To find out the prevalence of OHS and to determine the predictors of OHS among Indian SDB patients.Materials and Methods:It was a retrospective observational study conducted in a tertiary care institute from September 1, 2017, to August 31, 2018. All the patients who underwent polysomnography were analyzed for the presence of OHS. Of 85 patients referred for polysomnography, 76 had SDB. Thirteen patients were excluded because of hypoventilation due to other known causes or could not perform spirometry.Results:The prevalence of OHS among SDB after excluding the other causes of hypoventilation was 15.87% (10/63). The predictors were determined using univariate analysis between daytime partial pressure of carbon dioxide (PaCO2) and other predictors. PaCO2 significantly correlated with minimum nocturnal oxygen saturation by pulse oximetry (SpO2), FVC %predicted, BMI, daytime SpO2, forced expiratory volume %predicted, and partial pressure of oxygen (PaO2). Following a stepwise multiple regression, minimum nocturnal SpO2, FVC %predicted, and BMI were found to be independent predictors of OHS. A minimum nocturnal SpO2 threshold of 60%, FVC %predicted <74.5%, BMI >30.95 kg/m2, and absolute FVC <2.33 L for men and <1.68 L for women were found to be predictors of OHS.Conclusion:The prevalence of OHS in Indian patients is similar to Caucasians. OHS is seen in Indian patients even at a lower BMI and lower spirometric parameters.

Clinical features and predictors of obesity hypoventilation syndrome among patients with obstructive sleep apnea

Background Patients with obesity hypoventilation syndrome (OHS) have increased risk of cardiometabolic complications and higher mortality rate than obstructive sleep apnea (OSA) or eucapnic obese patients. So, understanding the clinical features and predictors of OHS is essential for early diagnosis. Aim of work To study the clinical features, predictors, and percentage of OHS among patients with OSA. Patients and methods Two groups were included OSA+OHS (34 patients, 42.5%) and pure OSA (46 patients, 57.5%) subjected to history taking, examination, body measurement, fasting blood sugar and postprandial blood sugar, lipid profile, arterial blood gases (ABGs), and polysomnography (PSG). Results OSA+OHS patients had higher waist circumference (P=0.020), lower PO2, O2 saturation%, higher PCO2 with higher bicarbonate in ABGs (P Conclusion Bicarbonate level, oxygen saturation values in ABGs and PSG were predictors of OHS among OSA patients.

The Predictors of Obesity Hypoventilation Syndrome in Obstructive Sleep Apnea.

Background:As obesity increases, the frequency of obstructive sleep apnea and obesity hypoventilation syndrome increases also. However, obesity hypoventilation syndrome frequency is not known, as capnography and arterial blood gas analysis are not routinely performed in sleep laboratories.Aims:To investigate the frequency and predictors of obesity hypoventilation syndrome in obese subjects.Study Design:Retrospective clinical study.Methods:Obese subjects who had arterial blood gas analysis admitted to the sleep laboratory and polysomnography were retrospectively analyzed. Subjects with restrictive (except obesity) and obstructive pulmonary pathologies were excluded. Demographics, Epworth-Sleepiness-Scale scores, polysomnographic data, arterial blood gas analysis, and spirometric measurements were recorded.Results:Of the 419 subjects, 45.1% had obesity hypoventilation syndrome. Apnea hypopnea index (p<0.001), oxygen desaturation index (p<0.001) and sleep time with SpO2<90% (p<0.001) were statistically higher in subjects with obesity hypoventilation syndrome compared to subjects with eucapnic obstructive sleep apnea. The nocturnal mean SpO2 (p<0.001) and lowest SpO2 (p<0.001) were also statistically lower in subjects with obesity hypoventilation syndrome. Logistic regression analysis showed that the lowest SpO2, oxygen desaturation index, apnea hypopnea index and sleep time with SpO2 <90% were related factors for obesity hypoventilation syndrome.Conclusion:Obesity hypoventilation syndrome should be considered when oxygen desaturation index, apnea hypopnea index and sleep time with SpO2 <90% are high.

Prevalence, clinical characteristics, and predictors of obesity hypoventilation syndrome in a large sample of Saudi patients with obstructive sleep apnea.

Objectives:To assess the prevalence, clinical characteristics, and predictors of obesity hypoventilation syndrome (OHS) in a large sample of Saudi patients with obstructive sleep apnea (OSA).Methods:This prospective observational study consisted of 1693 patients who were diagnosed to have sleep-disordered breathing using type I attended polysomnography (PSG) between January 2002 and December 2012 in the University Sleep Disorders Center (USDC) at King Saud University Hospital, Riyadh, Kingdom of Saudi Arabia.Results:Out of 1693 OSA patients, OHS was identified in 144 (8.5%) (women 66.7%). Compared with the pure OSA patients, the OHS patients were significantly older (57.4±13.4 years versus 46.8±13.7 years), had a higher body mass index (44.6±10.8 versus 35.7±9.2 kg/m2), a higher daytime partial pressure of carbon dioxide (PaCO2) (56.5±12.7 versus 41.6±6.7 mmHg), a longer duration of nocturnal oxygen saturation (nSaO2) <90% (71.0±34.3 versus 10.5±20.5 minutes), and a higher apnea hypopnea index (68.2±47.1 versus 46.5±34.1 events/hour). A multivariate logistic regression analysis showed that serum bicarbonate (odds ratio [OR]=1.17, p=0.0001, confidence interval [CI]=1.10-1.25), and duration of nSaO2 <90% (OR=1.05, p=0.0001, CI=1.04-1.06) were predictors of OHS.Conclusion:Obesity hypoventilation syndrome is common among Saudi OSA patients referred to the Sleep Disorders Center. Serum bicarbonate and duration of nSaO2 <90% are independent predictors of OHS among patients with OSA.

P261 Analysis of the Prevalence and Predictors of Obesity Hypoventilation Syndrome in a Cohort of Overweight Patients with Suspected Sleep Disordered Breathing

IntroductionThe need for early detection of Obesity Hypoventilation Syndrome (OHS) is clear because delay in the diagnosis and treatment is associated with significant morbidity and mortality.ObjectiveTo determine the prevalence of...