Sleep desaturation and its relationship to lung function, exercise and quality of life in LAM
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Citações na Scopus
13
Tipo de produção
article
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
W B SAUNDERS CO LTD
Citação
RESPIRATORY MEDICINE, v.106, n.3, p.420-428, 2012
Resumo
Background: Lymphangioleiomyomatosis (LAM) is characterised by progressive airway obstruction and hypoxaemia in young women. Although sleep may trigger hypoxaemia in patients with airway obstruction, it has not been previously investigated in patients with LAM. Methods: Consecutive women with lung biopsy proven LAM and absence of hypoxaemia while awake were evaluated with pulmonary function test, echocardiography, 6-min walk test, overnight full polysomnography, and Short Form 36 health-related quality-of-life questionnaire. Results: Twenty-five patients with (mean +/- SD) age 45 +/- 10 years, SpO(2) awake 95% +/- 2, forced expiratory volume in the first second (median-interquartile) FEV1 (% predicted) 77 (47-90) and carbonic monoxide diffusion capacity, DLCO (%) 55 (34-74) were evaluated. Six-minute walk test distance and minimum SpO(2) (median-interquartile) were, respectively, 447 m (411 -503) and 90% (82-94). Median interquartile apnoea-hypopnoea index was in the normal range 2 (1-5). Fourteen patients (56%) had nocturnal hypoxaemia (10% total sleep time with SpO(2) <90%), and the median sleep time spent with SpO(2) <90% was 136 (13-201) min. Sleep time spent with SpO(2) <90% correlated with the residual volume/total lung capacity ratio (r(s) = 0.5, p: 0.02), DLCO (r(s) = -0.7, p: 0.001), FEV1 (r(s) = -0.6, p: 0.002). Multivariate linear regression model showed that RV/TLC ratio was the most important functional variable related to sleep hypoxaemia. Conclusion: Significant hypoxaemia during sleep is common in LAM patients with normal SpO(2) while awake, especially among those with some degree of hyperinflation in lung function tests. (C) 2011 Published by Elsevier Ltd.
Palavras-chave
Lymphangioleio myomatosis (LAM), Polysomnography, Sleep hypoxaemia, Six-minute walk test, Lung function test
Referências
- BALLARD RD, 1995, AM J RESP CRIT CARE, V151, P945
- Becker HF, 1999, AM J RESP CRIT CARE, V159, P112
- Bissler JJ, 2008, NEW ENGL J MED, V358, P140, DOI 10.1056/NEJMoa063564
- BORG GAV, 1982, MED SCI SPORT EXER, V14, P377, DOI 10.1249/00005768-198205000-00012
- BOYSEN PG, 1979, CHEST, V76, P536, DOI 10.1378/chest.76.5.536
- Carvalho CRR, 2004, J BRAS PNEUMOL, V30, P66
- CATTERALL JR, 1983, AM REV RESPIR DIS, V128, P24
- Ciconelli PM, 1999, REV BRAS REUMATOL, V39, P143
- Dancey DR, 2001, CHEST, V120, P151, DOI 10.1378/chest.120.1.151
- DEMARCO FJ, 1981, CHEST, V79, P621, DOI 10.1378/chest.79.6.621
- DOUGLAS NJ, 1992, CLIN CHEST MED, V13, P523
- Drager LF, 2007, CHEST, V131, P1379, DOI 10.1378/chest.06-2703
- Enright PL, 1998, AM J RESP CRIT CARE, V158, P1384
- Farber HW, 2004, NEW ENGL J MED, V351, P1655, DOI 10.1056/NEJMra035488
- GRASSINO A, 1984, ANNU REV MED, V35, P625, DOI 10.1146/annurev.med.35.1.625
- Gries RE, 1996, CHEST, V110, P1489, DOI 10.1378/chest.110.6.1489
- JOHNS MW, 1991, SLEEP, V14, P540
- Johnson SR, 2010, EUR RESPIR J, V35, P14, DOI 10.1183/09031936.00076209
- Johnson SR, 2000, THORAX, V55, P1052, DOI 10.1136/thorax.55.12.1052
- Kelly J, 2001, AM J MED SCI, V321, P17, DOI 10.1097/00000441-200101000-00004
- KNUDSON RJ, 1983, AM REV RESPIR DIS, V127, P725
- Lama VN, 2003, AM J RESP CRIT CARE, V168, P1084, DOI 10.1164/rccm.200302-219OC
- LITTNER MR, 1980, AM REV RESPIR DIS, V122, P849
- MAHLER DA, 1984, CHEST, V85, P751, DOI 10.1378/chest.85.6.751
- Marcos E, 2003, AM J RESP CRIT CARE, V168, P487, DOI 10.1164/rccm.200210-1212OC
- Mohsenin V, 2005, SEM RESP CRIT CARE M, V26, P109, DOI 10.1055/s-2005-864204
- Moses MA, 2006, NEW ENGL J MED, V354, P2621, DOI 10.1056/NEJMc053410
- Neder JA, 1999, BRAZ J MED BIOL RES, V32, P729
- Netzer NC, 1999, ANN INTERN MED, V131, P485
- Pellegrino R, 2005, EUR RESPIR J, V26, P948, DOI 10.1183/09031936.05.00035205
- Pereira CAC, 2002, J PNEUMOL S3, V28
- PHILLIPSON EA, 1978, AM REV RESPIR DIS, V118, P909
- Pimenta SP, 2011, J BRAS PNEUMOL, V37, P424
- Ryu JH, 2006, AM J RESP CRIT CARE, V173, P105, DOI 10.1164/rccm.200409-1298OC
- Sullivan EJ, 1998, CHEST, V114, P1689, DOI 10.1378/chest.114.6.1689
- TARPY SP, 1995, NEW ENGL J MED, V333, P710, DOI 10.1056/NEJM199509143331107
- Taveira DaSilva AM, 2003, AM J RESP CRIT CARE, V168, P1427
- TAYLOR JR, 1990, NEW ENGL J MED, V323, P1254, DOI 10.1056/NEJM199011013231807
- West SD, 2009, BRIT MED J, V7, P338
- Zimmermann CS, 2007, BRAZ J MED BIOL RES, V40, P179, DOI 10.1590/S0100-879X2006005000056
- [Anonymous], 2002, AM J RESP CRIT CARE, V166, P111
- [Anonymous], 2004, DIRETRIZES INDICACOE, V82, P11