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The Role of Overnight Pulse-Oximetry in Recognition of Obstructive Sleep Apnea Syndrome in Morbidly Obese and Non Obese Patients
Background and objectives: Nocturnal pulse-oximetry is a screening method used in the diagnostic approach of Obstructive Sleep Apnea Syndrome (OSAS). As the pattern of the overnight pulse-oximetry is different in patients with morbid obesity, we assessed the role of overnight pulse-oximetry as a screening method in subjects with a BMI >40 kg/m2 and in those with a BMI <30 kg/m2 .
Material and methods: We prospectively evaluated 199 individuals with high pre-test clinical suspicion of OSAS. Of these, 123 patients were morbidly obese (Group A) and 76 were non-obese (Group B). We performed six channel cardio-respiratory polygraphy and assessed the correlation between the Desaturation Index (DI) and the Apnea Hypopnea Index (AHI) for both groups.
Results: In group A: 116 patients (94.3%) were diagnosed with OSAS (AHI>5/hour); mean age: 59.4±10.9 years; mean BMI: 44.8±4.9 kg/m2 . The mean DI was 47.2±27.6/hour and the mean AHI: 46.5±27.6/hour. Mean average SaO2 was 88.5±6.3 %. In group B, 65 patients (85.52%) were diagnosed with SAS; mean age: 51.2 ± 12.7 years; mean BMI: 27.24±2.2 kg/m2 .The mean DI was 23.12 ± 18.35/ hour and the mean AHI: 28.8 ± 18.5/hour. Mean average SaO2 was 93.7±2.07 %. A significant positive correlation (correlation index rA= 0.863 and rB= 0.877) was found between DI and AHI in both groups (p<0.001).
Conclusion: Assessment of the Desaturation Index by nocturnal pulse-oximetry maintains its utility as a screening method for OSAS in both obese and non-obese patients with high clinical pre-test suspicion, despite the fact that the basal nocturnal saturation was found to be lower in group A. Keywords: overnight pulse-oximetry, morbid obesity, desaturation index, sleep apnea
Keywords: overnight pulse-oximetry, morbid obesity, desaturation index, sleep apnea