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Inconsistent information exists about factors associated with daytime hypercapnia in obese patients with obstructive sleep apnea (OSA). We systematically evaluated these factors in this population.

We included studies evaluating the association between clinical and physiologic variables and daytime hypercapnia (Paco₂, ≥ 45 mm Hg) in obese patients (body mass index [BMI], ≥ 30 kg/m²) with OSA (apnea-hypopnea index [AHI], ≥ 5) and with a < 15% prevalence of COPD. Two investigators conducted independent literature searches using Medline, Web of Science, and Scopus until July 31, 2008. The association between individual factors and hypercapnia was expressed as the mean difference (MD). Random effects models were used to account for heterogeneity.

Fifteen studies (n = 4,250) fulfilled the selection criteria. Daytime hypercapnia was present in 788 patients (19%). Age …