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Analysis of nocturnal desaturation waveforms using algorithms in patients with idiopathic pulmonary fibrosis
Authors:Yasuda  Yuichiro  Nagano  Tatsuya  Izumi  Shintaro  Yasuda  Mina  Tsuruno  Kosuke  Tobino  Kazunori  Nakata  Kyosuke  Okamura  Kayoko  Nishiuma  Teruaki  Takatsuki  Kiyonobu  Funada  Yasuhiro  Ohnishi  Hisashi  Yamamoto  Masatsugu  Nishimura  Yoshihiro  Kobayashi  Kazuyuki
Affiliation:1.Department of Internal Medicine, Division of Respiratory Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
;2.Graduate School of System Informatics, Kobe University, 1-1-Rokkodai-cho, Nada-ku, Kobe, Hyogo, 657-8501, Japan
;3.Department of Respiratory Medicine, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka, Fukuoka, 820-0018, Japan
;4.Department of Respiratory Medicine, Kasai City Hospital, 1-13 Yoko, Hojo-cho, Kasai, Hyogo, 675-2311, Japan
;5.Department of Respiratory Medicine, Akashi Medical Center, 743-33 Yagi, Okubo-cho, Akashi, Hyogo, 674-0063, Japan
;6.Department of Respiratory Medicine, Kakogawa Central City Hospital, 439 Honmachi, Kakogawa-cho, Kakogawa, Hyogo, 675-8611, Japan
;7.Department of Respiratory Medicine, Kitaharima Medical Center, 926-250 Ichiba-cho, Ono, Hyogo, 675-1392, Japan
;8.Department of Respiratory Disease, Takatsuki General Hospital, 1-3-13 Kosobe-cho, Takatsuki, Osaka, 569-1192, Japan
;
Abstract:Purpose

Sleep-disordered breathing is recognized as a comorbidity in patients with idiopathic pulmonary fibrosis (IPF). Among them, nocturnal hypoxemia has been reported to be associated with poor prognosis and disease progression. We developed a diagnostic algorithm to classify nocturnal desaturation from percutaneous oxygen saturation (SpO2) waveform patterns: sustained pattern, periodic pattern, and intermittent pattern. We then investigated the prevalence of nocturnal desaturation and the association between the waveform patterns of nocturnal desaturation and clinical findings of patients with IPF.

Methods

We prospectively enrolled patients with IPF from seven general hospitals between April 2017 and March 2020 and measured nocturnal SpO2 and nasal airflow by using a home sleep apnea test. An algorithm was used to classify the types of nocturnal desaturation. We evaluated the association between sleep or clinical parameters and each waveform pattern of nocturnal desaturation.

Results

Among 60 patients (47 men) who met the eligibility criteria, there were 3 cases with the sustained pattern, 49 cases with the periodic pattern, and 41 cases with the intermittent pattern. Lowest SpO2 during sleep and total sleep time spent with SpO2?Conclusion

We demonstrated the prevalence of each waveform and association between each waveform and sleep parameters in patients with IPF. This classification algorithm may be useful to predict the degree of hypoxemia or the complication of obstructive sleep apnea.

Keywords:
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