Rajarajan, K (2015) Prevalence of Sleep Related Breathing Disorders and the Assessment of Quality of Sleep in Patients with Chronic Hypercapnic Respiratory Failure. Masters thesis, Stanley Medical College, Chennai.
|
Text
201700215rajarajan.pdf Download (2MB) | Preview |
Abstract
BACKGROUND: COPD will be the third leading cause of death by year 2020. In India, COPD and Post TuberculousSequelae are very common chronic respiratory diseases that have significant morbidity and mortality.Sleep related symptoms occur in about 40% of cases in patients with COPD. Sleep related breathing disorders constitute the greatest number of disorders of sleep in patients treated by sleep medicine, pulmonary, and general practitioners in the outpatient setting. AIM OF THE STUDY : 1. To know the prevalence of sleep related breathing disorders (SRBD) in patients with Chronic Hypercapnic Respiratory Failure. 2. To assess the quality of sleep in patients with Chronic Hypercapnic Respiratory Failure. MATERIAL AND METHODS: Patients enrolled in the COPD registry at Government Hospital of Thoracic Medicine Tambaram,with severe stable COPD or COPD with Pulmonary Tuberculosis Sequelaeare evaluated. Spirometry is done for those patients. Patients with FEV1< 40% by spirometry are included, Arterial Blood Gas analysis is done. Those with Chronic Hypercapnic Respiratory Failure are included in the study. Patients with similar degree of obstruction without Respiratory Failure are used as comparison group. Overnight Polysomnography was performed in those patients. Epworths Sleepiness Score and Pittsburg sleep quality index scoring is done. Data is analyzed by standard statistical methods. RESULTS: Forty Five patients are enrolled into the study in total. Thirty two patients are Patients with Chronic Hypercapnic Respiratory Failure (Group A). Thirteen patients had COPD or COPD with Pulmonary Tuberculosis sequelae and with similar degrees of airflow obstruction without Respiratory failure (Group B).The mean Age group is 57.2 vs 57.8 years. Significant Nocturnal Desaturation is seen in 68.8% of patients with Group A and 38.5% of patients in Group B. Snoring is present in 41% of Group A and 23.07% of Group B. Obstructive Sleep apnea is seen in 2 patients in Group A (6.25%). Sleep latency (in minutes) is 62.7 vs 42.4. arousal index is 31.1/hour vs 20.4/ hour, NREM1, 2 (in Minutes) 208.1 vs 180.1, NREM3 (Min) is 20.7 vs 33.9, REM (min) 34.7 vs 48.6. In Group A, 68.8 % of patients have significant nocturnal desaturation vs 38.5% in Group B. Mean Epworth Sleepiness score is 11.5 vs 9.7, MeanPSQI score is 13.2vs 7.3. CONCLUSION: Nocturnal Desaturation is seen in significant proportion of patients with Chronic Hypercapnic Respiratory Failure (68.8%). There is good correlation between the Quality of sleep measurement by Pittsburgh Sleep Quality Index scoring and the sleep variables determined by polysomnography. Patients with Chronic Hypercapnic Respiratory Failure have decreased Total Sleep Time, Increased Sleep Latency, Decreased Sleep Efficiency, Decreased NREM Stage 3 Sleep, Decreased REM Sleep, Increased Arousal, Increase in duration of Wake after Sleep Onset when compared to normal values of that age. Based on these variables it is concluded that Sleep Quality in patients with Chronic Hypercapnic Respiratory Failure is poor. The prevalence of sleep related breathing disorders (SRBD) in patients with Chronic Hypercapnic Respiratory Failure is 6.25% which is similar to that general population.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Sleep related breathing disorders (SRBD) ; Quality of sleep ; Chronic hypercapnic respiratory failure ; Polysomnography. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Punitha K |
| Date Deposited: | 06 May 2018 04:14 |
| Last Modified: | 06 May 2018 04:14 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7525 |
Actions (login required)
 |
View Item |
