Advertisement

Sleep and Breathing

, Volume 7, Issue 4, pp 159–165 | Cite as

Pulmonary Function and Sleep Apnea

  • Victor HoffsteinEmail author
  • Zoe Oliver
Original Article

Abstract

The purpose of this study was to determine whether there is a relationship between pulmonary function measured during wakefulness and sleep apnea. We prospectively studied 1296 patients, who were free of any lung disease, referred to our sleep clinic for evaluation of possible sleep apnea. All patients had in-hospital nocturnal polysomnography and pulmonary function measurements, which included flow-volume curve, body plethysmography, and single-breath diffusing capacity for carbon monoxide. The results were analyzed by comparing pulmonary function data between four groups of patients, grouped according to apnea severity as reflected by their apnea/hypopnea index: nonapneics (apnea-hypopnea index ≤ 10), mild apnea (10 < apnea-hypopnea index ≤ 30), moderate apnea (30 < apnea-hypopnea index ≤ 50), and severe apnea (apnea-hypopnea index > 50). Analysis of covariance demonstrated no difference in any of the pulmonary function parameters between the four groups, after adjusting for age, body mass index, or weight as the covariate. We conclude that in nonsmoking patients without lung disease, sleep apnea is unrelated to pulmonary function measured during wakefulness.

Keywords

Sleep apnea pulmonary function spirometry body plethysmography diffusing capacity polysomnography 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Fogel RB, White DP. Obstructive sleep apnea. Adv Intern Med 2000;45:351–389Google Scholar
  2. 2.
    Rubinstein I, Zamel N, Du Barry L, et al. Airflow limitation in morbidly obese non-smoking men. Ann Intern Med 1990;112:828–832Google Scholar
  3. 3.
    Sanders MH, Martin RJ, Pennock BE, et al. The detection of sleep apnea in the awake patient: the “saw-tooth” sign. JAMA 1981;245:2414–2418Google Scholar
  4. 4.
    Haponik EF, Bleecker ER, Allen RP, et al. Abnormal inspiratory flow-volume curves in patients with sleep-disordered breathing. Am Rev Respir Dis 1981;124:571–574Google Scholar
  5. 5.
    Hoffstein V, Wright S, Zamel N. Flow-volume curves in snoring patients with and without obstructive sleep apnea. Am Rev Respir Dis 1989;139:957–960Google Scholar
  6. 6.
    Katz I, Zamel N, RebuckAS, et al. An evaluation of flow-volume curves as a screening test for obstructive sleep apnea. Chest 1990;98:337–339Google Scholar
  7. 7.
    Sériès F, Marc I. Accuracy of breath-by-breath analysis of flow-volume loop in identifying sleep-induced flow-limited breathing cycles in sleep apnoea-hypopnoea syndrome. Clin Sci 1995;88:707–712Google Scholar
  8. 8.
    Stanescu D, Kostianev S, Sanna A, et al. Expiratory flow limitation during sleep in heavy snorers and obstructive sleep apnea patients. Eur Respir J 1996;9:2116–2121Google Scholar
  9. 9.
    Liistro G, Veriter C, Dury M, et al. Expiratory flow limitation in awake sleep-disordered breathing subjects. Eur Respir J 1999;14:185–190Google Scholar
  10. 10.
    Campbell AH, Guy PA, Rochford PD, et al. Flow-volume curve changes in patients with obstructive sleep apnoea and brief upper airway dysfunction. Respirology 2000;5:11–18Google Scholar
  11. 11.
    Hoffstein V, Brown I, Taylor R, McLean P, Zamel N. Flow ratios at mid-vital capacity in normal men and women. Chest 1986;90:857–860Google Scholar
  12. 12.
    Hoffstein V. Relationship between smoking and sleep apnea in clinic population. Sleep 2002;25:519–524Google Scholar
  13. 13.
    American Thoracic Society. Standardization of spirometry: 1994 update. Am J Respir Crit Care Med 1995;152:1107–1136.Google Scholar
  14. 14.
    American Thoracic Society. Lung function testing: selection of reference values and interpretive strategies. Am Rev Respir Dis 1991;144:1202–1218Google Scholar
  15. 15.
    Cody RP, Smith JK. Applied Statistics and the SAS Programming Language, 4th ed. Upper Saddle River, NJ: Prentice-Hall; 1997Google Scholar
  16. 16.
    Zerah-Lancner F, Lofaso F, Coste A, et al. Pulmonary function in obese snorers with or without sleep apnea syndrome. Am J Respir Crit Care Med 1997;156:522–527Google Scholar
  17. 17.
    Gold AR, Schwartz AR, Wise RA, et al. Pulmonary function and respiratory chemosensitivity in moderately obese patients with sleep apnea. Chest 1993;103:1325–1329Google Scholar
  18. 18.
    Stauffer JL, White DP, Zwillich CW. Pulmonary function in obstructive sleep apnea: relationships to pharyngeal resistance and cross-sectional area. Chest 1990;97:302–307Google Scholar
  19. 19.
    de Miguel J, Cabello J, Sánchez-Alarcos JMF, Álvarez-Sala R, Espinós D, Álvarez-SalaJL. Long-term effects of treatment with nasal continuous positive airway pressure on lung function in patients with overlap syndrome. Sleep Breath 2002;6:3–10Google Scholar
  20. 20.
    Collard P, Wilputte JY, AubertG, et al. The single-breath diffusing capacity for carbon monoxide in obstructive sleep apnea and obesity. Chest 1996;110:1189–1193Google Scholar
  21. 21.
    Zamarrón C, Gude F, AlvarezJM, et al. Airway disorders and pulmonary function in snorers; a population-based study. Respir Med 2000;94:835–840Google Scholar
  22. 22.
    Larsson LG, Lundbäck B, Jönsson E, et al. Are symptoms of obstructive sleep apnea syndrome related to bronchitic symptoms or lung function impairment?. Report from the obstructive lung disease in Northern Sweden study. Respir Med 1998;92:283–288Google Scholar
  23. 23.
    Chaouat A, Weitzenblum E, Krieger J, et al. Prognostic value of lung function and pulmonary hemodynamics in OSA patients treated with CPAP. Eur Respir J 1999;13:1091–1096Google Scholar
  24. 24.
    Zerah-Lancner F, Lofaso F, D’Ortho MP, et al. Predictive value of pulmonary function parameters for sleep apnea syndrome. Am J Respir Crit Care Med 2000;162:2208–2212Google Scholar

Copyright information

© Thieme Medical Publishers, Inc. 2003

Authors and Affiliations

  1. 1.Department of MedicineSt. Michael’s Hospital, University of TorontoTorontoCanada
  2. 2.St. Michael’s HospitalTorontoCanada

Personalised recommendations