{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T03:19:25Z","timestamp":1773803965681,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: We aimed to investigate the occurrence of sleep-related breathing disorders (SRBDs) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and addressed the effect of pulmonary hemodynamics and SRBD indices on the severity of nocturnal hypoxemia (NH). Methods: An overnight polysomnography (PSG) was conducted in patients with CTEPH, who were eligible for pulmonary endarterectomy. Pulmonary hemodynamics (mean pulmonary arterial pressure (mPAP), pulmonary arterial wedge pressure (PAWP), pulmonary vascular resistance (PVR) measured with right heart catheterization (RHC)), PSG variables (apnea\u2013hypopnea index (AHI)), lung function and carbon monoxide diffusion capacity (DLCO) values, as well as demographics and comorbidities were entered into a logistic regression model to address the determinants of severe NH (nocturnal oxyhemoglobin saturation (SpO2) &lt; 90% under &gt;20% of total sleep time (TST)). SRBDs were defined as obstructive sleep apnea (OSA; as an AHI \u2265 15 events\/h), central sleep apnea with Cheyne\u2013Stokes respiration (CSA\u2013CSR; CSR pattern \u2265 50% of TST), obesity hypoventilation syndrome (OHS), and isolated sleep-related hypoxemia (ISRH; SpO2 &lt; 88% under &gt;5 min without OSA, CSA, or OHS). Results: In all, 50 consecutive patients (34 men and 16 women; mean age 54.0 (SD 15.1) years) were included. The average mPAP was 43.8 (SD 16.8) mmHg. SRBD was observed in 40 (80%) patients, of whom 27 had OSA, 2 CSA\u2013CSR, and 11 ISRH. None had OHS. Severe NH was observed in 31 (62%) patients. Among the variables tested, age (odds ratio (OR) 1.08, 95% confidence interval [CI] 1.01\u20131.15; p = 0.031), mPAP (OR 1.11 [95% CI 1.02\u20131.12; p = 0.012]), and AHI (OR 1.17 [95% CI 1.02\u20131.35; p = 0.031]) were independent determinants of severe NH. Conclusions: Severe NH is highly prevalent in patients with CTEPH. Early screening for SRBDs and intervention with nocturnal supplemental oxygen and\/or positive airway pressure as well as pulmonary endarterectomy may reduce adverse outcomes in patients with CTEPH.<\/jats:p>","DOI":"10.3390\/jcm12144639","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T01:58:11Z","timestamp":1689213491000},"page":"4639","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Determinants of Severe Nocturnal Hypoxemia in Adults with Chronic Thromboembolic Pulmonary Hypertension and Sleep-Related Breathing Disorders"],"prefix":"10.3390","volume":"12","author":[{"given":"Caner","family":"\u00c7\u0131nar","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, School of Medicine, Marmara University, Istanbul 34854, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3236-3995","authenticated-orcid":false,"given":"\u015eehnaz Olgun","family":"Y\u0131ld\u0131zeli","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, School of Medicine, Marmara University, Istanbul 34854, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baran","family":"Balcan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, School of Medicine, Ko\u00e7 University, Istanbul 34450, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bedrettin","family":"Y\u0131ld\u0131zeli","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, School of Medicine, Marmara University, Istanbul 34854, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u00fclent","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine, Marmara University, Istanbul 34854, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-6538","authenticated-orcid":false,"given":"Y\u00fcksel","family":"Peker","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, School of Medicine, Ko\u00e7 University, Istanbul 34450, Turkey"},{"name":"Department of Molecular and Clinical Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden"},{"name":"Department of Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, 221 00 Lund, Sweden"},{"name":"Division of Sleep and Circadian Disorders, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02115, USA"},{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1801913","DOI":"10.1183\/13993003.01913-2018","article-title":"Haemodynamic definitions and updated clinical classification of pulmonary hypertension","volume":"53","author":"Simonneau","year":"2019","journal-title":"Eur. 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