SLEEP, AROUSALS, AND OXYGEN DESATURATION IN CHRONIC OBSTRUCTIVE PULMONARY-DISEASE - THE EFFECT OF OXYGEN-THERAPY

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Abstract
To assess the role of hypoxemia in the sleep disruption of patients with COPD [chronic obstructive pulmonary disease], patients were studied breathing air and O2 during sleep. In 24 patients with COPD, the 95% confidence bands for arterial O2 saturation (SaO2) were determined in the various sleep stages. The lowest mean SaO2 was during REM [rapid eye movement] sleep. Patients spent 22.4% of the night desaturated (SaO2 > 5% below awake SaO2). Apneic episodes were uncommon and occurred in only 2 patients. When compared with established age-matched normal subjects from another center, poor sleep quality was indicated by reduced sleep time, increased sleep stage changes and increased arousal frequency. O2 therapy had no apparent effect on sleep quality. Arousal frequency was independent of measurements of awake pulmonary function or chemical control of breathing. During room air breathing, arousals were strongly associated with periods of arterial O2 desaturation. Relief of the hypoxemia with supplemental O2 had no effect on arousal frequency. This suggests that it is not hypoxemia per se but an associated phenomenon such as hypercapnia that causes the arousals.