Pulmonary hypertension in recently diagnosed obstructive sleep apnea patients

Abstract

Background: Obstructive sleep apnea (OSA) is a condition characterized by daytime sleepiness, with occurrence of ≥ 5 obstructive events per hour during sleep, associated with cyclic oxygen desaturation. The cumulative effect of intermittent hypoxia can lead to pulmonary hypertension (PH). The study aimed to assess the association of PH with recently diagnosed OSA.

Methods: Fifty newly diagnosed OSA patients with PH were included. Their PH was diagnosed based on echocardiographic findings. They seemed to have PH, if mean pulmonary artery pressure (mPAP) ≥25 mmHg.

Results: 42 patients (84%) reported daytime sleepiness, 41 (82%) were snorers, 37 patients (74%) experienced witnessed apnea, 36 patients (72%) reported tiredness or fatigue, 27 patients (54%) suffered from choking and 22 patients (44%) reported nocturia. Mean snoring index was 304.85 (±290.60) events/hour. On the other hand, 20% of moderate OSA patients had mild PH, 33.3% had moderate PH and 46.7% had severe PH. Finally, the percentages of mild, moderate, and severe PH in severe OSA patients were 12%, 28% and 60% respectively. There was a significant association between OSA severity and both approximated pulmonary artery systolic pressure (PASP) & approximated mPAP. Approximated PASP was significantly higher in severe OSA than mild and moderate OSA (75.3 vs 69.8 vs. 52.3 mmHg respectively, p =0.018). Approximated mPAP was significantly higher in patients with severe OSA than patients with mild and moderate OSA (47.93 vs. 44.6 vs. 33.9 mmHg respectively, p =0.016

Conclusions: PH and its degree are directly correlated to OSA and its severity