دراسة نسبة انتشار و العوامل المنبئة لحدوث متلازمة نقص التهوية المتعليقة بالبدانة (OHS)‎ عند مرضى توقف التنفس الانسدادي أثناء النوم (OSA)‎

الملخص EN

Background: Patients with obesity hypoventilation syndrome (OHS) suffer from lower quality of life, increased healthcare expenses, and a higher mortality rate compared to eucapnic patients with obstructive sleep apnea (OSA).

Despite significant morbidity and mortality rates associated with OHS, it is often unrecognized, and treatment is frequently delayed.

Objective: The objective of this observational study was to determine the prevalence of OHS in patients with OSA seen at the Sleep Disorders Clinic in Al-Assad University hospital Damascus, Syria.

Secondly, to identify independent clinical predictors that should prompt clinicians to measure arterial blood gases in order to determine the prevalence of OHS in patients with OSA.

Lastly, to identify the presence of comorbidities in patients suffering from OSA, overlap syndrome (OS) (the coexistence of OSA and chronic obstructive pulmonary disease (COPD)), OHS and the differences in these groups of patients.

Materials and Methods: 179 patients were collected from the sleep disorders laboratory between September 2018 and September 2020 for suspicion of OSA.

Among these patients 47% were diagnosed with OSA, 17.3% with OHS and 12.3% with OS.

Sleep disordered breathing syndromes were found more prevalent in male (62%).

Results: This study showed that 62.2% of patients had hypertension, as the most prevalent comorbidity associated with sleep disordered breathing syndromes, 26.3% had DM II, and 13.3% had ischemic heart disease (IHD).

When comparing the three syndromes, patients with OHS had the highest BMI (mean 43.15 kg/m2), The deepest oxygen desaturation during the sleep study (75.8%) and the lowest baseline oxygen saturation was (83%).

The study showed several clinical predictors that indicate the presence of OHS among OSA.

These predictors are serum bicarbonate (a good predictor with more than 70% sensitivity and specificity, and a negative predictive value of 93.7%), and baseline oxygen saturation (a fair predictor).

Conclusion: the coexistence of OHS and OSA raises the prevalence of comorbidities.

The clinical approach and the management of these syndromes are different, highlighting the importance of early diagnosis.

There is a lack of studies associated with these syndromes in Syria, therefore it is expected that this study will improve the quality of life of patients and decrease the mortality rate.