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Sleepiness and nocturnal hypoxemia in Peruvian men with obstructive sleep apnea

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Abstract

Purpose

To evaluate the intensity of nocturnal hypoxemia associated with sleepiness in Peruvian men with a diagnosis of obstructive sleep apnea (OSA).

Methods

We carried out a secondary data analysis based on a study which includes patients with OSA who were seen in a private hospital in Lima, Peru from 2006 to 2012. We included male adults who had polysomnographic recordings and who answered the Epworth sleepiness scale (ESE). The intensity of nocturnal hypoxemia (oxygen saturation ≤90 %) was classified in four new categories: 0, <1, 1 to 10 and >10 % total sleep time with nocturnal hypoxemia (NH). When the ESE score was higher than 10, we used the definitions presence or absence of sleepiness. We used Poisson regression models with robust variance to estimate crude and adjusted prevalence ratios (PR) for association between sleepiness and NH.

Results

518 male patients with OSA were evaluated. Four hundred and fifty-two (87 %) patients had NH and 262 (51 %) had sleepiness. Of the 142 (27.4 %) patients who had >10 % total sleep time with NH, 98 (69.0 %) showed sleepiness and had a greater probability of sleepiness prevalence, with a crude PR of 1.82 (95 % CI 1.31–2.53). This association persisted in the multivariate models.

Conclusions

We found an association between NH and sleepiness. Only patients with the major intensity of NH (over 10 % of the total sleep time) had a greater probability of sleepiness. This suggests that sleepiness probably occurs after a chronic process and after overwhelming compensatory mechanisms.

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Acknowledgments

Thanks to Dr. Kim Hoffman for her recommendations on the final version of this manuscript. This study was developed as part of the activities of the Masters in Clinical Epidemiology offered jointly by the Cayetano Heredia University and the US Naval Medical Research Unit Six (NAMRU-6), Peru. This Master of Science (MSc) programme is sponsored by 2D43 TW007393 “Peru Epidemiology Research Training Consortium”, awarded to NAMRU-6 by the Fogarty International Center of the US National Institutes of Health. The first author (CHS) prepared this paper to meet the graduation requirements of this programme.

Conflict of interest

The authors indicate that there are no financial conflicts of interest

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Authors and Affiliations

  1. Instituto Nacional de Salud, Lima, Peru

    Charles Huamaní & Edward Mezones-Holguín

  2. Universidad Peruana Cayetano Heredia, Lima, Peru

    Charles Huamaní & Jorge Rey de Castro

  3. Centro de Trastornos Respiratorios del Sueño (CENTRES), Clínica Anglo Americana, Lima, Peru

    Jorge Rey de Castro

  4. Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru

    Edward Mezones-Holguín

  5. Av. Arriba Perú 1154, Lima, 42, Peru

    Charles Huamaní

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  1. Charles Huamaní
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Correspondence to Charles Huamaní.

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Huamaní, C., Rey de Castro, J. & Mezones-Holguín, E. Sleepiness and nocturnal hypoxemia in Peruvian men with obstructive sleep apnea. Sleep Breath 18, 467–473 (2014). https://doi.org/10.1007/s11325-013-0907-3

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  • DOI: https://doi.org/10.1007/s11325-013-0907-3

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