Evaluating nocturnal oxygen desaturation in COPD--revised

Respir Med. 2011 Sep;105(9):1331-7. doi: 10.1016/j.rmed.2011.04.003. Epub 2011 May 10.


Background: Although in patients with COPD, the approach to daytime hypoxemia using long-term oxygen therapy (LTOT) is established, the best approach to transient nocturnal desaturation varies among clinicians. An understanding of the prevalence of nocturnal desaturation in COPD, in the absence of other respiratory co-morbidities, is an important step towards its standardized management.

Methods: We conducted a 5 site cross-sectional study of stable patients with COPD and mild-to-moderate daytime hypoxemia (PaO(2) 56-69 mmHg). Nocturnal saturation was monitored using home oximetry on 2 occasions over a 2-week period. Patients were classified in 3 categories: (A) no significant nocturnal desaturation; (B) significant nocturnal desaturation without evidence of sleep apnea; (C) significant nocturnal desaturation with evidence of sleep apnea.

Results: In 128 patients (mean FEV(1): 37% predicted), we noted an excellent test-retest reliability between the 2 oximetries. Forty-nine patients (38%) were classified as nocturnal desaturators without evidence of sleep apnea, and 20 patients (16%) were classified as desaturators with evidence of sleep apnea. Nocturnal desaturation without sleep apnea could not be predicted by any patient characteristic or physiological measure.

Conclusions: A significant proportion (38%) of patients with moderate-to-severe COPD who do not qualify for home oxygen therapy based on their daytime PaO(2) have nocturnal oxygen desaturation without evidence of sleep apnea. Home oximetry is an effective practical method for screening this population.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Canada
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Humans
  • Hypoxia / metabolism
  • Hypoxia / physiopathology
  • Hypoxia / therapy*
  • Male
  • Oximetry / methods*
  • Oxygen Inhalation Therapy / methods*
  • Oxygen Inhalation Therapy / standards
  • Pilot Projects
  • Polysomnography
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Reproducibility of Results
  • Respiratory Function Tests
  • Sleep Apnea Syndromes / metabolism
  • Sleep Apnea Syndromes / physiopathology
  • Sleep Apnea Syndromes / therapy*