Getting Older is Associated with the Increased Risk for OSA and Hypoventilation in Patients with Duchenne Muscular Dystrophy
Date Issued
2018
Author(s)
Abstract
Background and Aims: Background: Duchenne muscular dystro- phy (DMD) is characterized as progressive muscle wasting and eventually results in respiratory insufficiency. Obstructive sleep apnoea (OSA) and hypoventilation were prevalent in DMD. Nevertheless, nocturnal hypoven-tilation (NH) has been associated with respiratory failure in DMD. Although early identifying OSA and NH may facilitate early treatment but clinical associated factors have not been fully elucidated.
Aims: To identify clinical factors associated with OSA and percentage of total sleep time spent on transcutaneous CO2 >50 mmHg (%TSTof PtcCO2>50 mmHg) in non-invasive-ventilation-naïve DMD.
Methods: Medical records of patients with DMD, 5 to 18 y/o, referred to sleep lab for suspicious OSA from Jan. 2009 to Feb. 2018 were reviewed. OSA was defined as obstructive apnoea-hypopnea (AHI>1 /h) while hypoventilation was defined as %TST of PtcCO2>50 mmHg higher than 25%. Multivariable logistic regression was applied to identified clini- cal factors independently associated with OSA and %TST of PtcCO2>50 mmHg where the result was expressed as (odds ratio (OR) or coefficient; 95% confidence interval (CI)).
Results: Totally, 42 boys with DMD were enrolled with the man age of 9.65 years and body mass index (BMI) z score of −0.01. 64% had OSA and 10% had NH. OSA patients were older than non-OSA patients and two groups had similar pulmonary function parameters including forced vital capacity (FVC) and forced expiratory volume in the first sec-
ond (FEV1). NH patients were also older than non-NH patients. Age was the only factor independently associated with OSA (OR 1.637; 95% CI 1.03–12.597) and %TST of PtcCO2>50 mmHg (coefficient 3.537; 95%CI 0.994 to 6.080) after controlling BMI, FVC, and FEV1.
Conclusion: OSA was prevalent in DMD. Age was the independent factors for both of the OSA and %TST of PtcCO2>50 mmHg.