Defining of the Relationship Between Lung Volumes, Airway Resistance and the Apnea-Hypopnea Index
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Original Article
P: 6-11
March 2018

Defining of the Relationship Between Lung Volumes, Airway Resistance and the Apnea-Hypopnea Index

J Turk Sleep Med 2018;5(1):6-11
1. İstanbul Süreyyapaşa Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği, İstanbul, Türkiye
2. Acıbadem Mehmet Ali Aydınlar Üniversitesi, Atakent Hastanesi, Göğüs Hastalıkları Kliniği, İstanbul, Türkiye
No information available.
No information available
Received Date: 20.12.2017
Accepted Date: 22.02.2018
Publish Date: 12.06.2018
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ABSTRACT

Objective:

Obstructive Sleep Apnea syndrome (OSAS) is characterized by recurrent complete or partial narrowing of the upper respiratory tract during sleep and frequently a decrease in blood oxygen saturation. Upper respiratory tract gap is determined by the balance between collapsing effect of negative intraluminal pressure during inspiration and upper airway dilator muscle activity. In this study, we aimed to describe the relationship among the lung volumes and airway resistance, which are not thought to be directly taken a part in OSAS pathogenesis, and OSAS cases at different severity.

Materials and Methods:

Our study has been conducted on 105 cases 26 (24.8%) of which are female and 79 (75.2%) male who were applied polisomnography in the Ministry of Health İstanbul Süreyyapaşa Chest Diseases and Chest Surgery Training and Research Hospital, Chest Disease Clinic between January 2008 and May 2008. Whole body plethysmography was performed to cases which filled patient information form containing identity informations, body mass index (BMI), neck circumference, additional disease situation, smoking anamnesis and Epworth sleepiness scale (ESS). Pulmonary function tests, lung volumes and airway resistances were recorded by looking at the expected % values for age, color and weight.

Results:

Patients were divided into 4 groups according to apnea-hypopnea index; 25.7% of them were diagnosed with simple snoring, 21.9% mild OSAS, 22.9% moderate OSAS, and 29.5% severe OSAS. The expiratory reserve volume (ERV) in severe OSAS was found lower than the other OSAS groups. No difference was determined in terms of respiratory function tests, airway resistance and lung volumes. While the BMI and neck circumference were high in the severe OSAS group, there was no difference among the groups in the ESS according to the severity of the disease.

Conclusion:

In conclusion, in our study OSAS severity is not affected by other lung volumes except airway resistance and ERV.

Keywords: Obstructive sleep apnea, lung volumes, airway resistance

References

1
International Classification of Sleep Disorders: Diagnostic and Coding Manual. 2. Westchester: American Academy of Sleep Medicine; 2005.
2
Artwood CW. Obstructive sleep apnea. Clinical Presentation in Sleep Syllabus 2006;44-8.
3
White DP. Pathogenesis of obstructive and central sleep apnea. Am J Respir Crit Care Med 2005;172:1363-70.
4
Köktürk O, Köktürk N. Obstrüktif uyku apne sendromu fizyopatolojisi. Tüberküloz ve Toraks 1998;46:288-300.
5
Dempsey JA, Veasey SC, Morgan BJ, O’Donnell CP. Pathophysiology of sleep apnea. Physiol Rev 2010;90:47.
6
Haponik E, Smith P, Bohlman M, Allan R, Goldman S, Bleecker E. Computerized tomography in obstructive sleep apnea: correlation of airway size with physiology during sleep and wakefulness. Am Rev Respir Dis 1983;127:221-6.
7
Katz I, Zarne N, Slutsky S, Rebuck S, Hoffstein V. An Evaluation of Flow-Volume Curves as a Screening Test for Obstructive Sleep Apnea. Chest 1990;98:337-40.
8
Hoffstein V, Zamel N, Phillipson EA. Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnea. Am Rev Respir Dis 1984;130:175-8.
9
Rubinstein I, Hoffstein V, Bradley TD. Lung volume-related changes in the pharyngeal area of obese females with and without obstructive sleep apnoea. Eur Respir J 1989;2:344-51.
10
Onal E, Leech JA, Lopata M. Relationship between pulmonary function and sleep-induced respiratory abnormalities. Chest 1985;87:437-41.
11
Appelberg J, Nordahl G, Janson C. Lung volume and its correlation to nocturnal apnoea and desaturation. Respir Med 2000;94:233-9.
12
Jones RL, Nzekwu MM. The effects of body mass index on lung volumes. Chest 2006;130:827-33.
13
Zerah-Lancner F, Lofaso F, Coste A, Ricolfi F, Goldenberg F, Harf A. Pulmonary function in obese snorers with or without sleep apnea syndrome. Am J Respir Crit Care Med 1997;156:522-7.
14
Stauffer JL, White D, Zwillich W. Pulmonary Function in Obstructive Sleep Apnea Relationships to Pharyngeal Resistance and Cross-Sectional Area. Chest 1990;97:302-7.
15
Zerah F, Harf A, Perlemuter L, Lorino H, Lorino AM, Atlan G. Effects of obesity on respiratory resistance. Chest 1993;103:1470-6.
16
Behazin N, Jones SB, Cohen RI, Loring SH. Respiratory restriction and elevated pleural and esophageal pressures in morbid obesity. J Appl Physiol (1985) 2010;108:212-8.
17
Kaminsky DA. Spirometry and related tests. In: Ruppel GL (ed). Manual of Pulmonary Function Testing. 9th ed. Chapter 2, Mosby Elsevier, 2009:36-89.
18
Kay A, Trinder J, Kim Y. Progressive changes in airway resistance during sleep. J Appl Physiol 1996;81:282-92.
19
Stanchina ML, Malhotra A, Fogel RB, Trindler J. Edwards Jk, Schory K, White DP. The influence of lung volume on pharyngeal mechanics, collapsibility and genioglossus muscle activation during sleep. Sleep 2003;26:851.
20
Kıyan E; Solunum Fonksiyon testleri; Türk Toraks derneği V Kış Okulu Notları 2006;Selçuk/İzmir.
21
Sanders MH, Martin RJ, Pennock BE, Rogers RM. The detection of sleep apnea in the awake patient. The ‘saw-tooth’ sign. JAMA 1981;245:2414-8.
22
Katz I, Zarne N, Slutsky S, Rebuck S, Hoffstein V. An Evaluation of Flow-Volume Curves as a Screening Test for Obstructive Sleep Apnea. Chest 1990;98:337-40.
23
Krieger J, Weitzenblum E, Vandevenne A, Stierle JL, Kurtz D. Flow-volume curve abnormalities and obstructive sleep apnea syndrome. Chest 1985;87:163-7.
24
Abdeyrim A, Zhang Y, Li N, Zhao M, Wang Y, Yao X, Keyoumu Y, Yin T. Impact of obstructive sleep apnea on lung volumes and mechanical properties of the respiratory system in overweight and obese individuals. BMC Pulm Med 2015;15:76.
25
Kauffmann F, Annesi I, Neukirch F, Oryszczyn MP, Alperovitch A. The relation between snoring and smoking, body mass index, age, alcohol consumption and respiratory symptoms. Eur Respir J 1989;2:599-603.
26
Franklin KA, Gíslason T, Omenaas E, Jõgi R, Jensen EJ, Lindberg E, Gunnbjörnsdóttir M, Nyström L, Laerum BN, Björnsson E, Torén K, Janson C. The Influence of Active and Passive Smoking on Habitual Snoring. Am J Respir Crit Care Med 2004;170:799-803. Epub 2004 Jul 8.
27
Cohes-ZionM, Gehrman PR, Ancoli-Israil S. Sleep in the elderly. In: Lee Chiong TL, Sateia MJ, Carskadon MA (eds). Sleep Medicine. Hanley and Belfus, Philadelphia, USA 2002;115-23.
28
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurence of sleep disordered breathing among middle aged adults N Engl J Med 1993;328:1230-5.
29
Schwartz AR, Patil SP, Laffan AM, Polotsky V, Schneider H, Smith PL. Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proc Am Thorac Soc 2008;5:185-92.
30
Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal Study of Moderate Weight Change and Sleep-Disordered Breathing. JAMA 2000;284:3015-21.
31
Stradling JR, Crosby JH. Predictors and prevalence of obstructive sleep apnea and snoring in 1001 middle aged men. Thorax 1991;46:85-90.
32
Davies RJ, Ali NJ, Stradling JR. Neck circumference and other clinical features inthe diagnosis of the obstructive sleep apnoea syndrome. Thorax 1992;47:101-5.
33
Chervin RD, Aldrich MS, Pickett R, Guilleminault C. Comparison of the results of the Epworth Sleepiness Scale and the Multiple Sleep Latency Test. J Psychosom Res 1997;42:145-55.
34
Chervin RD, Aldrich MS. The Epworth Sleepiness Scale may not reflect objective measures of sleepiness or sleep apnea. Neurology 1999;52:125-31.
35
Johns MW. Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest 1993;103:30-6.
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