Prévalence du SAOS chez les patients avec lymphœdème hospitalisés pour traitement décompressif.

Objective: Obstructive sleep apnea (OSA) syndrome is one of the most frequent chronic diseases in the general population. The nocturnal rostral fluid shift is accepted as a key mechanism in OSA pathogenesis in medical conditions associated with fluid overload. The main objective of this study was to assess the prevalence of OSA in patients with lymphedema.

Methods: A prospective study was conducted in patients with lymphedema hospitalized for complete decongestive therapy between December 2016 and November 2017. A nocturnal respiratory polygraphy, an Epworth sleepiness scale, and lymphedema volume measurements were performed on the first day of decongestive therapy. OSA was diagnosed in patients with an apnea-hypopnea index of five or more events per hour and patients who had been previously diagnosed with OSA and treated by continuous positive airway pressure were identified.

Results: Forty-three patients completed the study. The prevalence of OSA was 74% and was higher for patients with lymphedema of the lower limbs (85%) vs upper limbs (56%). OSA severity was correlated with a marker of lower limb lymphedema severity (P = .012). The body mass index was higher than in patients with OSA than patients without OSA (median, 31.0 kg/m2 [25th; 75th percentiles, 25.3; 37.0 kg/m2] vs median, 24.2 kg/m2 [25th; 75th percentiles, 22.7; 26.7 kg/m2]; P < .01). Hypertension was prevalent in 47% of patients with OSA vs 18% in patients without OSA.

Conclusions: Patients with lymphedema presenting for complete decongestive therapy present a high prevalence rate of OSA, particularly in those with lower limb lymphedema. OSA severity was correlated with a marker of lower limb lymphedema severity. These results suggest that overweight and obese patients with lymphedema should be screened systematically for OSA.