We enrolled 165 outpatients diagnosed with COPD who fulfilled the following inclusion criteria: aged 20 years or older diagnosed with stable COPD and daytime PaO 2 ≥ 55 Torr (SpO 2 ≥ 88%). The current study was conducted with the approval of the Ethics Committees or Institutional Review Board of Kobe University Hospital (permission number: 160208). This study was performed between September 2017 and March 2020. Therefore, in the present study, we aimed to adapt the algorithm for patients with mild to moderate COPD who were not receiving oxygen therapy and analyse the association between the waveform patterns and the clinical features of COPD. In clarifying the pathophysiology of desaturation, it is important to classify the desaturation pattern. Moreover, we developed a diagnostic algorithm to automatically analyse these waveforms. Then, we found that each waveform was composed of a combination of three desaturation patterns: intermittent pattern, sustained pattern and periodic pattern. In our previous study, we analysed nocturnal SpO 2 waveforms obtained from patients with chronic respiratory diseases receiving home oxygen therapy (HOT), and we showed that the SpO 2 waveforms were very diverse. Although nocturnal desaturation may have an important impact on patients with COPD, less research has been focused on the waveform patterns of desaturation. As COPD progresses, it has been reported that nocturnal desaturations in COPD contribute to the development of daytime respiratory failure, the frequency of acute exacerbations and the development of pulmonary hypertension and are associated with poor survival. Even patients with mild to moderate COPD have lower total sleep duration, lower sleep efficacy and worse sleep quality due to insomnia and awakenings at night, leading to a lower quality of life. We found that nocturnal desaturation was frequently observed in patients with COPD and could be classified into 3 types of waveform patterns.Ĭhronic obstructive pulmonary disease (COPD) is a highly prevalent disease worldwide, and sleep-related desaturation in COPD is well known. Intriguingly, desaturation with an intermittent pattern was associated with the apnoea-hypopnea index obtained with the portable monitor, and desaturation with a sustained pattern was associated with the cumulative percentage of time at a SpO 2 below 90%. One hundred twenty-eight of the 153 (83.7%) patients had nocturnal desaturation, with an intermittent pattern (70.6%), sustained pattern (13.1%) and periodic pattern (68.0%). One hundred fifty-three patients (136 male and 17 female) were analysed. Then, we classified the SpO 2 waveforms with the algorithm and compared the clinical data. We investigated patients diagnosed with COPD and measured SpO 2 and nasal airflow with a type 4 portable long-term recordable pulse oximeter. In this study, we aimed to investigate nocturnal desaturation in patients with COPD based on SpO 2 waveform patterns and the associations between the waveforms and clinical data. In our previous study, we developed a diagnostic algorithm to classify nocturnal desaturation from SpO 2 waveform patterns based on data from patients receiving home oxygen therapy. Nocturnal desaturation is common in patients with chronic obstructive pulmonary disease (COPD) and impacts disease exacerbation and prognosis.
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