Universität zu Köln

Herkenrath, Simon D., Treml, Marcel, Hagmeyer, Lars, Matthes, Sandhya and Randerath, Winfried J. (2022). Severity stages of obesity-related breathing disorders - a cross-sectional cohort study. Sleep Med., 90. S. 9 - 17. AMSTERDAM: ELSEVIER. ISSN 1878-5506

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Abstract

Introduction: There is a general underappreciation of the spectrum of obesity-related breathing disorders and their consequences. We therefore compared characteristics of obese patients with eucapnic obstructive sleep apnea (OSA), OSA with obesity-related sleep hypoventilation (ORSH) or obesity hypoventilation syndrome (OHS) to identify the major determinants of hypoventilation. Patients and methods: In this prospective, diagnostic study (NCT04570540), obese patients with OSA, ORSH or OHS were characterized applying polysomnography with transcutaneous capnometry, blood gas analyses, bodyplethysmography and measurement of hypercapnic ventilatory response (HCVR). Pathophysiological variables known to contribute to hypoventilation and differing significantly between the groups were specified as potential independent variables in a multivariable logistic regression to identify major determinants of hypoventilation. Results: Twenty, 43 and 19 patients were in the OSA, ORSH and OHS group, respectively. BMI was significantly lower in OSA as compared to OHS. The extent of SRBD was significantly higher in OHS as compared to OSA or ORSH. Patients with ORSH or OHS showed a significantly decreased forced expiratory volume in 1 s and forced vital capacity compared to OSA. HCVR was significantly lower in OHS and identified as the major determinant of hypoventilation in a multivariable logistic regression (Nagelkerke R-2 = 0.346, p = 0.050, odds ratio (95%-confidence interval) 0.129 (0.017-1.004)). Conclusion: Although there were differences in BMI, respiratory mechanics and severity of upper airway obstruction between groups, our data support HCVR as the major determinant of obesity-associated hypoventilation. (C) 2022 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herkenrath, Simon D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Treml, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagmeyer, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Matthes, Sandhya UNSPECIFIED UNSPECIFIED UNSPECIFIED Randerath, Winfried J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-662589
DOI:	10.1016/j.sleep.2021.12.015
Journal or Publication Title:	Sleep Med.
Volume:	90
Page Range:	S. 9 - 17
Date:	2022
Publisher:	ELSEVIER
Place of Publication:	AMSTERDAM
ISSN:	1878-5506
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OBSTRUCTIVE SLEEP-APNEA; EXPIRATORY LUNG-VOLUME; HYPOVENTILATION SYNDROME; OXYGEN COST; CLINICAL CHARACTERISTICS; VENTILATORY RESPONSE; HEART-FAILURE; WEIGHT-LOSS; EXERCISE; HYPERCAPNIA Multiple languages Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66258