Skip to main content
SpringerLink
Log in

Obstructive Airway Disease and Obstructive Sleep Apnea: Effect of Pulmonary Function

  • Published:
Lung Aims and scope Submit manuscript

Abstract

This study sought to determine whether reduced pulmonary function in obstructive airway disease (OAD) is an independent risk factor for obstructive sleep apnea (OSA). This was a prospective observational study conducted at an outpatient pulmonary clinic. Adults with a known diagnosis of COPD/asthma were enrolled as OAD group. Family members without a history of COPD/asthma who accompanied these patients to the clinic were enrolled as a control group. The Berlin Questionnaire (BQ) was used to assess OSA risk in the OAD group and controls. Forced expiratory volume in 1 second (FEV1 % predicted) was determined from spirometry. The subjects at high risk for OSA were referred for a full overnight polysomnogram (PSG). The prevalence of patients with a high risk of OSA was 55.2% in the OAD group, which was higher than in the controls (7.5%, p < 0.0001). OAD subjects had a higher body mass index (BMI) and larger neck circumference than controls (p < 0.01). There was no difference in FEV1 % predicted between the OAD patients at high risk and low risk of OSA. On receiver operator curve (ROC) analysis, FEV1 % predicted was not a significant predictor of high OSA risk. Using logistic regression, FEV1 % predicted had no association with OSA risk. There was no correlation between FEV1 % predicted and total apnea–hypopnea index (AHI), oxygen desaturation index, % time spent below oxygen saturation 90%, and mean oxygen saturation on multiple regression analysis. OSA appears to be common in patients with COPD or asthma in an urban outpatient pulmonary clinic. However, the high prevalence of OSA in OAD patients appears to be due to obesity, and reduced pulmonary function is not an independent risk factor for OSA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Tishler PV, Larkin EK, Schluchter MD, Redline S (2003) Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA 289:2230–2237

    Article  PubMed  Google Scholar 

  2. Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239

    Article  PubMed  Google Scholar 

  3. Auckley D, Moallem M, Shaman Z, Mustafa M (2008) Findings of a Berlin Questionnaire survey: comparison between patients seen in an asthma clinic versus internal medicine clinic. Sleep Med 9:494–499

    Article  PubMed  Google Scholar 

  4. Alharbi M, Almutairi A, Alotaibi D, Alotaibi A, Shaikh S, Bahammam AS (2009) The prevalence of asthma in patients with obstructive sleep apnoea. Prim Care Respir J 18:328–330

    Article  PubMed  Google Scholar 

  5. Julien JY, Martin JG, Ernst P, Olivenstein R, Hamid Q, Lemière C, Pepe C, Naor N, Olha A, Kimoff RJ (2009) Prevalence of obstructive sleep apnea–hypopnea in severe versus moderate asthma. J Allergy Clin Immunol 124:371–376

    Article  PubMed  Google Scholar 

  6. Yigla M, Tov N, Solomonov A, Rubin AH, Harlev D (2003) Difficult-to-control asthma and obstructive sleep apnea. J Asthma 40:865–871

    Article  PubMed  Google Scholar 

  7. ten Brinke A, Sterk PJ, Masclee AA, Spinhoven P, Schmidt JT, Zwinderman AH, Rabe KF, Bel EH (2005) Risk factors of frequent exacerbations in difficult-to-treat asthma. Eur Respir J 26:812–818

    Article  CAS  PubMed  Google Scholar 

  8. Ramagopal M, Scharf SM, Roberts DW, Blaisdell CJ (2008) Obstructive sleep apnea and history of asthma in snoring children. Sleep Breath 12:381–392

    Article  PubMed  Google Scholar 

  9. Flenley DC (1985) Sleep in chronic obstructive lung disease. Clin Chest Med 6:51–61

    Google Scholar 

  10. Guilleminault C, Cummiskey J, Motta J (1980) Chronic obstructive airflow disease and sleep studies. Am Rev Respir Dis 122:397–406

    CAS  PubMed  Google Scholar 

  11. Chaouat A, Weitzenblum E, Krieger J, Ifoundza T, Oswald M, Kessler R (1995) Association of chronic obstructive pulmonary disease and sleep apnea syndrome. Am Rev Respir Dis 151:82–86

    CAS  Google Scholar 

  12. Sanders MH, Newman AB, Haggerty CL, for the Sleep Heart Health Study (2003) Sleep and sleep-disordered breathing in adults with predominantly mild obstructive airway disease. Am J Respir Crit Care Med 167:7–14

    Article  PubMed  Google Scholar 

  13. Bednarek M, Plywaczewski R, Jonczak L, Zielinski J (2005) There is no relationship between chronic obstructive pulmonary disease and obstructive sleep apnea syndrome: a population study. Respiration 72:142–149

    Article  PubMed  Google Scholar 

  14. Marin JM, Soriano JB, Carrizo SJ, Boldova A, Celli BR (2010) Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med 182:325–331

    Article  PubMed  Google Scholar 

  15. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP (1999) Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 131:485–491

    CAS  PubMed  Google Scholar 

  16. Miller MR, Hankinson J, Brusasco V, ATS/ERS Task Force (2005) Standardisation of spirometry. Eur Respir J 26:319–338

    Article  CAS  PubMed  Google Scholar 

  17. American Academy of Sleep Medicine (2007) AASM Manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. American Academy of Sleep Medicine, Darien, IL

    Google Scholar 

  18. Kinsman RA, Yaroush RA, Fernandez E, Dirks JF, Schocket M, Fukuhara J (1983) Symptoms and experiences in chronic bronchitis and emphysema. Chest 83:755–761

    Article  CAS  PubMed  Google Scholar 

  19. Global Initiative for Asthma (GINA) Scientific Committee (2007) Global strategy for asthma management and prevention. Available at http://www.ginasthma.com/download.asp?intId=411. Accessed 17 Sept 2010

  20. Camargo CA Jr, Weiss ST, Zhang S, Willett WC, Speizer FE (1999) Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med 159:2582–2588

    Article  PubMed  Google Scholar 

  21. Teodorescu M, Consens FB, Bria WF, Coffey MJ, McMorris MS, Weatherwax KJ, Palmisano J, Senger CM, Ye Y, Kalbfleisch JD, Chervin RD (2009) Predictors of habitual snoring and obstructive sleep apnea risk in patients with asthma. Chest 135:1125–1132

    Article  PubMed  Google Scholar 

  22. Kimoff RJ, Sforza E, Champagne V, Ofiara L, Gendron D (2001) Upper airway sensation in snoring and obstructive sleep apnea. Am J Respir Crit Care Med 164:250–255

    CAS  PubMed  Google Scholar 

  23. Kimoff RJ (2007) Upper airway myopathy is important in the pathophysiology of obstructive sleep apnea. J Clin Sleep Med 3:567–569

    PubMed  Google Scholar 

  24. Hoffstein V, Zamel N, Phillipson EA (1984) Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnea. Am Rev Respir Dis 130:175–178

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Sleep Medicine, Harvard Medical School/Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Bhavneesh Sharma & David McSharry

  2. Division of Pulmonary and Critical Care Medicine, New York University School of Medicine, New York, NY, 10016, USA

    Steven Feinsilver

  3. Divisions of Pulmonary and Critical Care and Sleep Medicine, Harvard Medical School/Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Robert L. Owens & Atul Malhotra

  4. Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College/New York Hospital Queens, Flushing, NY, 11355, USA

    Stephen Karbowitz

  5. Division of Sleep Disorders Research, Harvard Medical School/Brigham and Women’s Hospital, 221 Longwood Avenue, BLI 035M, Boston, MA, 02115, USA

    Bhavneesh Sharma

Authors
  1. Bhavneesh Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven Feinsilver
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert L. Owens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atul Malhotra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David McSharry
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Stephen Karbowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bhavneesh Sharma.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sharma, B., Feinsilver, S., Owens, R.L. et al. Obstructive Airway Disease and Obstructive Sleep Apnea: Effect of Pulmonary Function. Lung 189, 37–41 (2011). https://doi.org/10.1007/s00408-010-9270-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-010-9270-3

Keywords

Search

Navigation