Can oxygen desaturation during gastrointestinal endoscopy under conscious sedation predict obstructive sleep apnea?

Objective: This study explored whether oxygen desaturation during gastrointestinal endoscopy under conscious sedation could serve as a predictive marker for obstructive sleep apnea (OSA). Methods: In this retrospective chart review, adults who underwent both polysomnography (PSG) and gastrointestinal endoscopy under conscious sedation were divided into two groups based on the lowest oxygen saturation: desaturation group (≤90 %) and non-desaturation group (>90 %). PSG metrics were compared, and associations between procedural desaturation and OSA severity were analyzed using linear-by-linear association and Pearson correlation tests. Multiple linear regression with stepwise selection was used to identify independent predictors of apnea-hypopnea index (AHI). Results: Among 48 patients, 22 were in the desaturation group and 26 were in the non-desaturation group. The desaturation group exhibited significantly higher AHI, hypopnea index, respiratory disturbance index, oxygen desaturation index, and cumulative time with O₂ saturation below 90 %, indicating more severe OSA-related metrics. A significant linear trend (P = 0.045) suggested a higher likelihood of severe OSA in the desaturation group. Additionally, the lowest oxygen saturation during endoscopy correlated negatively with key PSG metrics. In multiple linear regression analysis, the lowest oxygen saturation during endoscopy showed a negative association with AHI, with borderline significance (standardized β = −0.25, P = 0.058, variance inflation factor = 1.173). Conclusions: Oxygen desaturation during gastrointestinal endoscopy under conscious sedation is associated with more severe OSA and may serve as a useful clinical indicator. PSG should be considered in patients experiencing desaturation during endoscopy.