April 1986

Oxygen Saturation With Sleep in Patients With Sickle Cell Disease

Author Affiliations

From the Department of Medicine, Case Western Reserve University, Cleveland, and Cleveland Metropolitan General Hospital.

Arch Intern Med. 1986;146(4):722-725. doi:10.1001/archinte.1986.00360160150020

• Ear oximetry was used to monitor arterial oxygenation in seven patients who had a history of frequent admissions for sickle cell crisis and were taking narcotic analgesics. Five fullnight studies and seven daytime "nap" studies were performed in which sleep state was monitored by electroencephalography, and respiratory rate and tidal volume were monitored by inductance plethysmography. For all patients the mean (±SEM) of the median oxygenation values was 93.3%±0.4% during wakefulness and 91.4%±0.8% during sleep. During wakefulness the lowest saturation was 90% ±0.5%; during sleep there was a fall in the lowest oxygen saturation to 86.5%±0.9%. In all patients a fall in oxygen saturation was associated with a decrease in respiratory depth without a change in respiratory frequency. The results indicate that in sickle cell disease oxygen saturation is lower during sleep than during wakefulness and that hypoxemia can be attributed to a fall in tidal volume.

(Arch Intern Med 1986;146:722-725)