| Popis: |
Background Obesity hypoventilation syndrome (OHS) is defined as hypoxemia with morning hypercapnia in obese patients;90% are associating OSA. The influence of gender in patients with OHS and OSA is insufficient described. Aims Retrospective study evaluating differences (clinical, paraclinical, sleep parameters) between women and men with OHS in a Romanian OSA cohort. Methods Among files of 100 OSA patients (2012-2015) we found 15 patients with OHS. Exclusion criteria: COPD, pulmonary fibrosis, kyphoscoliosis, neuromuscular disease. Demographics, diurnal arterial blood gases, spirometry, sleep study (diagnostic and under positive airway pressure (PAP) therapy) data were analyzed using SPSS 17. Results 67% (10) men, mean values: age 53.13+/-13.78 years, AHI 61.12+/-30.05/h (100% severe OSA), nocturnal SaO 2 68.84+/-12.44%; morning PO 2 46.53+/-8.10 mmHg, PCO 2 52.49+/-5.40mmHg, HCO 3 29.47+/-3.98 mmol/L; efficient PAP therapy in all patients. There were no significant differences between genders regarding comorbidities, symptoms, smoking status, Epworth score, OSA severity, mean PAPs values, body mass index and abdominal index, degree of ventilator restriction, morning PCO 2 and HCO 3 , mean hospitalization days. Men were younger (48.20+/-14.03 vs 63.0+/-6.2years, p=0.045), with longer time spent in bed (455.00+/-41.23 vs 295.33+/-107.07min, p=0.038). The morning PCO 2 at hospital discharged was still abnormal in men, and higher than in women (48.20+/-8.42 vs 37.94+/-6.65 mmHg, p=0.048). Conclusions Taking in account the fast and appropriate response to PAP therapy in women, we conclude that is a need for a better understanding of OHS underlying mechanism in respect to gender. |
