Clinical Significance of Sleep Desaturation in Hypoxemic Chronic Obstructive Pulmonary Disease: Studies in 130 Patients

We studied 130 patients with hypoxemic chronic obstructive lung disease to determine if nocturnal desaturation aggravates hypoxia-induced complications. All had tests of neuropsychological and physiological function known to be affected by chronic hypoxia. Of the 130 patients, 25 had complete polysomnography and 105 had their sleep judged visually and arterial oxygen saturation recorded continuously. Severe and mild desaturation groups were defined relative to the mean for both mean and maximal sleep desaturation, and the severity of waking complications were compared. No significant differences were noted between patients with mild and severe mean desaturation or maximal desaturation for hematocrit, neuropsychological tests, maximal exercise tolerance, or measures of quality of life. Waking pulmonary artery pressure did not differ significantly between patients with mild and severe mean desaturation or maximal desaturation, except in 20 patients with the most severe mean desaturation during sleep. We conclude that nocturnal desaturation does not aggravate hypoxia-induced complications in most patients who are chronically hypoxemic from chronic obstructive pulmonary disease.