Lung Function Capacities in Obstructive Sleep Apnea Syndrome

  • Abolhasan Halvani Department of Internal Medicine, School of Medicine, Yazd Medical Science Branch, Islamic Azad University, Yazd, Iran
  • Shahrzad Sabzevari Department of Internal Medicine, School of Medicine, Yazd Medical Science Branch, Islamic Azad University, Yazd, Iran
  • Mehrdad Mostaghaci Department of Occupational and Environmental Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  • Amir Houshang Mehrparvar Department of Occupational Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  • Mohammad Javad Zare Sakhvidi Department of Occupational Health, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  • Raziyeh Soltani Gerdfaramarzi Department of Occupational Medicine, School of Medicine, Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Keywords: Spirometry, Obstructive sleep apnea syndrome, Polysomnography

Abstract

Background and Objective: Previous studies have reported abnormal changes in spirometric parameters and flow-volume curves in patients with obstructive sleep apnea syndrome (OSAS) during sleep. This study aimed to evaluate the lung function capacities and flow-volume curves in these patients. Materials and Methods:This was a cross-sectional study. A total of 120 adults aged 18-65 years with suspected OSAS were selected. A full record of demographic characteristics and history of chronic diseases, as well as the results of spirometry and polysomnography were obtained. Spirometric indices and flow-volume curves in OSAS patients and normal subjects were compared. Results:The mean body mass index was 30.85 ± 6.18 kg/m2. Average neck and abdominal circumferences were 41.68 ± 3.53 and 108.56 ± 14.34 (cm); respectively. The subjects were divided into three groups based on their AHI. The sawtooth signal was observed in a flow-volume curve in 20.2% and 2.8% of patients with and without OSAS; respectively. Significant differences were seen in sawtooth appearance signs and forced expiratory flow (FEF) 50/forced inspiratory flow (FIF) 50 (P > 0.001), but these parameters were not significantly different in AHI subgroups of sleep apnea. Conclusion:Sawtooth sign and FEF50/FIF50 ≥ 1 could be useful in diagnosis of OSAS, although it cannot be used to predict the severity. Despite a significant difference in a sawtooth sign and FEF50/FIF50 between OSAS patients and nor-mal subjects, no significant differences in lung functions were observed between OSAS patients and normal subjects.

References

Epstein LJ, Kristo D, Strollo PJ Jr, et al. Clini-cal guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 2009; 5: 263-76.

Sleep-related breathing disorders in adults: Recommendations for syndrome definition and meas-urement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999; 22: 667-89.

Franklin K, Rehnqvist N, Axelsson S. Obstruc-tive sleep apnoea syndrome. Report of a joint Nordic project. Helsinki, Finland: Finnish Office for Health Care Technology Assessment; 2007.

Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA 2004; 291: 2013-6.

Duran J, Esnaola S, Rubio R, et al. Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med 2001; 163: 685-9.

Yaggi HK, Concato J, Kernan WN, et al. Ob-structive sleep apnea as a risk factor for stroke and death. N Engl J Med 2005; 353: 2034-41.

Young T, Peppard PE, Gottlieb DJ. Epidemiol-ogy of obstructive sleep apnea: A population health perspective. Am J Respir Crit Care Med 2002; 165: 1217-39.

Neukirch F, Weitzenblum E, Liard R, et al. Fre-quency and correlates of the saw-tooth pattern of flow-volume curves in an epidemiological survey. Chest 1992; 101: 425-31.

Levent E, Sariman N. Analysis of obstructive sleep apnea patients with "sawtooth sign" on the flow-volume curve. Sleep Breath 2011; 15: 357-65.

Soriano JB, Zielinski J, Price D. Screening for and early detection of chronic obstructive pulmonary disease. Lancet 2009; 374: 721-32.

Sahni S, Blood A, Paulus S, et al. "Saw-tooth sign" in upper airway disorders-a case report. Pneu-monol Alergol Pol 2015; 83: 140-3.

Haponik EF, Bleecker ER, Allen RP, et al. Ab-normal inspiratory flow-volume curves in patients with sleep-disordered breathing. Am Rev Respir Dis 1981; 124: 571-4.

Sanders MH, Martin RJ, Pennock BE, et al. The detection of sleep apnea in the awake patient. The 'saw-tooth' sign. JAMA 1981; 245: 2414-8.

Shore ET, Millman RP. Abnormalities in the flow-volume loop in obstructive sleep apnoea sitting and supine. Thorax 1984; 39: 775-9.

Krieger J, Weitzenblum E, Vandevenne A, et al. Flow-volume curve abnormalities and obstructive sleep apnea syndrome. Chest 1985; 87: 163-7.

Hoffstein V, Wright S, Zamel N. Flow-volume curves in snoring patients with and without obstructive sleep apnea. Am Rev Respir Dis 1989; 139: 957-60.

Katz I, Zamel N, Slutsky AS, et al. An evaluation of flow-volume curves as a screening test for obstructive sleep apnea. Chest 1990; 98: 337-40.

Amado VM, Costa AC, Guiot M, et al. Inspira-tory flow-volume curve in snoring patients with and without obstructive sleep apnea. Braz J Med Biol Res 1999; 32: 407-11.

Campbell AH, Guy PA, Rochford PD, et al. Flow-volume curve changes in patients with obstruc-tive sleep apnoea and brief upper airway dysfunction. Respirology 2000; 5: 11-8.

Hoffstein V, Oliver Z. Pulmonary function and sleep apnea. Sleep Breath 2003; 7: 159-65.

Ozturk L, Metin G, Cuhadaroglu C, et al. FEF(25-75)/FVC measurements and extrathoracic air-way obstruction in obstructive sleep apnea patients. Sleep Breath 2005; 9: 33-8.

Ashraf M, Shaffi SA, BaHammam AS. Spirom-etry and flow-volume curve in patients with obstructive sleep apnea. Saudi Med J 2008; 29: 198-202.

Sharma B, Feinsilver S, Owens RL, et al. Ob-structive airway disease and obstructive sleep apnea: effect of pulmonary function. Lung 2011; 189: 37-41.

ATS/ERS recommendations for standardized pro-cedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med 2005; 171: 912-30.

Kushida CA, Littner MR, Morgenthaler T, et al. Practice parameters for the indications for poly-somnography and related procedures: An update for 2005. Sleep 2005; 28: 499-521.

McNicholas WT, Bonsigore MR. Sleep apnoea as an independent risk factor for cardiovascular dis-ease: current evidence, basic mechanisms and research priorities. Eur Respir J 2007; 29: 156-78.

Published
2018-02-13
How to Cite
1.
Halvani A, Sabzevari S, Mostaghaci M, Mehrparvar AH, Zare Sakhvidi MJ, Soltani Gerdfaramarzi R. Lung Function Capacities in Obstructive Sleep Apnea Syndrome. JSS. 2(1-2):1-.
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Original Article(s)