The correlations between pulmonary function tests and polysomnographic parameters in overlap syndrome
Öz
Aim: This study aims to reveal the relationship between Pulmonary Function Tests (PFTs) parameters and polysomnographic parameters. It aims to determine the guiding values in treatment selection, with the hypothesis that easily accessible PFTs parameters can be useful in clinical evaluation for patients with restrictive or obstructive type disorders.
Material and Method: One hundred and forty-six patients with obstructive and/or restrictive pulmonary dysfunction who underwent polysomnography in the sleep clinic of our hospital between June 2019 and December 2019 were included in the study. Polysomnography (PSG) parameters and PFTs results were obtained. Age, gender, body mass index (BMI), Epworth Sleepiness Scale (ESS) score, PFTs parameters, apnea-hypopnea index (AHI), nocturnal oxygen saturation, tolerable positive airway therapy modality, and pressures were recorded.
Results: Of 146 patients 34.9% were women and most (92.5%) had an obstructive disorder in PFTs. Of the patients with the obstructive disorder, 71 were being followed up with a diagnosis of chronic obstructive pulmonary disease (COPD) and 64 with a diagnosis of asthma. Interstitial lung disease was observed in 5 out of 11 cases (7.5%) with restrictive type disorder, and obesity resulted in restrictive disorder for the remaining 6 cases. Simple snoring was observed in 5.5%. Mild OSAS was observed at a rate of 30.1%. Moderate-severe OSAS was detected in 64.4% of the patients. When the relationship between optimal inspiratory/ expiratory positive airway pressure (IPAP/EPAP) values determined by automatic bilevel positive airway pressure (ABPAP) titration and PFTs parameters were analyzed, a moderate negative correlation was observed between IPAP value and forced vital capacity (FVC) (L) (r=-0.432, p=0035)
Discussion: The results of this study show that PFTs parameters can be used to predict polysomnographic findings for patients with obstructive/restrictive disorders. Almost two-thirds of the patients with obstructive sleep apnea (OSA)-related symptoms in this group were observed to have moderate-severe obstructive sleep apnea syndrome (OSAS). Based on our results in ROC analysis, we believe that it would be appropriate to recommend titration with bilevel devices, especially for patients with forced expiratory volume in one second (FEV1)<60% and maximum expiratory flow between 25% and 75% of FVC (MEF25-75)<30%. Bilevel devices may be useful for patients with reduced MEF25-75 (representing peripheral airways), through alveolar recruitment and pressure support.
Conclusion: In our study, we demonstrated that the optimal IPAP value for treatment had a positive correlation with the oxygen desaturation index (ODI) and AHI and a negative correlation with minimum finger pulse oximetry (SpO2), as well as a negative correlation with FVC value. Simple spirometric data along with polysomnographic data can also be helpful when determining baseline pressures in bilevel positive airway pressure (BPAP) titration for OSAS patients with respiratory dysfunction.
Proje Numarası
yok
Kaynakça
- Carvalho TMDCS, Soares AF, Climaco DCS, Secundo IV, Lima AMJ. Correlation of lung function and respiratory muscle strength with functional exercise capacity in obese individuals with obstructive sleep apnea syndrome. J Bras Pneumol 2018; 44: 279-84.
- Kairaitis K, Byth K, Parikh R, Stavrinou R, Wheatley JR, Amis TC. Tracheal traction effects on upper airway patency in rabbits: the role of tissue pressure. Sleep 2007; 30: 179–86.
- Owens RL, Malhotra A, Eckert DJ, White DP, Jordan AS. The influence of end-expiratory lung volume on measurements of pharyngeal collapsibility. J Appl Physiol (1985) 2010; 108: 445–5
- Zerah F, Harf A, Perlemuter L, Lorino H, Lorino AM, Atlan G. Effects of obesity on respiratory resistance. Chest 1993; 103: 1470–6.
- Babb TG, Wyrick BL, DeLorey DS, Chase PJ, Feng MY. Fat distribution and end expiratory lung volume in lean and obese men and women. Chest 2008; 134: 704–11.
- Hoffstein V, Oliver Z. Pulmonary function and sleep apnea. Sleep Breath 2003; 7: 159-65.
- Akiba Y, Nakano H, Osanai S, et al. Pulmonary function and the pathogenesis of obstructive sleep apnea syndrome. Nihon Kyobu Shikkan Gakkai Zasshi 1995; 33: 1212-8.
- Schreiber A, Surbone S, Malovini A. The effect of continuous positive airway pressure on pulmonary function may depend on the basal level of forced expiratory volume in 1 second. J Thorac Dis 2018; 10: 6819-27.
- Marin JM, Soriano JB, Carrizo SJ, Boldova A, Celli BR. Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med 2010; 182: 325-31.
- Abdeyrim A, Zhang Y, Li N, et al. 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.
- Graham BL, Teenbruggen I, Miller MR. Standardization of spirometry 2019 update an official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care MedVol 2019; 200: e70–e88.
- Berry RB, Brooks R, Gamaldo CE, et al. for the American Academy of Sleep Medicine. The AASM Manual for the scoring of sleep and associated events: rules, terminology, and technical specifications, Version2.3 2008 www.aasmnet.org. Darien, Illinois: American Academy of Sleep Medicine.
- Ramsey R, Mehra R, Strohl KP. Variations in physician interpretation of overnight pulse-oximetry monitoring.Chest 2007; 132: 852-9.
- Kushida CA, Chediak A, Berry RB, et al. Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnoea. Positive Airway Pressure Titration Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2008; 4: 157-71.
- Shawon MS, Perret JL, Senaratna CV, Lodge C, Hamilton GS, Dharmage SC. Current evidence on prevalence and clinical outcomes of co-morbid obstructive sleep apnea and chronic obstructive pulmonary disease: a systematic review. Sleep Med Rev 2017; 32: 58–68
- Lacedonia D, Carpagnano GE, Aliani M,et al. Daytime PaO2 in OSAS, COPD and the combination of the two (overlap syndrome). RespirMed 2013; 107: 310-6.
- Kuklisova Z, Tkacova R, Joppa P, Wouters E, Sastry M. Severity of nocturnal hypoxia and daytime hypercapnia predicts CPAP failure in patients with COPD and obstructive sleep apnea overlap syndrome. Sleep Med 2017; 30: 139-45.
- Sanders MH, Newman AB, Haggerty CL, et al. for the Sleep Heart Health Study. Sleep and sleep disordered breathing in adults with predominantly mild obstructive airway disease. Am J Respir Crit Care Med 2003; 167: 7-14.
- Owens RL. Supplemental oxygen needs during sleep. Who benefits? Respir Care 2013; 58: 32-47.
- Makarawate P, Senthong V, Sawanyawisuth K. Cpap Pressure by Cpap Titration or Prediction Formula. J Sleep Disorders Ther 2013, 2: 4.
- Camacho M, Riaz M, Tahoori A, Certal V, Kushida CA. Mathematical equations to predict positive airway pressures for obstructive sleep apnea: a systematic review. Sleep Disord 2015; 2015: 293868.
Öz
Destekleyen Kurum
yok
Proje Numarası
yok
Teşekkür
yok
Kaynakça
- Carvalho TMDCS, Soares AF, Climaco DCS, Secundo IV, Lima AMJ. Correlation of lung function and respiratory muscle strength with functional exercise capacity in obese individuals with obstructive sleep apnea syndrome. J Bras Pneumol 2018; 44: 279-84.
- Kairaitis K, Byth K, Parikh R, Stavrinou R, Wheatley JR, Amis TC. Tracheal traction effects on upper airway patency in rabbits: the role of tissue pressure. Sleep 2007; 30: 179–86.
- Owens RL, Malhotra A, Eckert DJ, White DP, Jordan AS. The influence of end-expiratory lung volume on measurements of pharyngeal collapsibility. J Appl Physiol (1985) 2010; 108: 445–5
- Zerah F, Harf A, Perlemuter L, Lorino H, Lorino AM, Atlan G. Effects of obesity on respiratory resistance. Chest 1993; 103: 1470–6.
- Babb TG, Wyrick BL, DeLorey DS, Chase PJ, Feng MY. Fat distribution and end expiratory lung volume in lean and obese men and women. Chest 2008; 134: 704–11.
- Hoffstein V, Oliver Z. Pulmonary function and sleep apnea. Sleep Breath 2003; 7: 159-65.
- Akiba Y, Nakano H, Osanai S, et al. Pulmonary function and the pathogenesis of obstructive sleep apnea syndrome. Nihon Kyobu Shikkan Gakkai Zasshi 1995; 33: 1212-8.
- Schreiber A, Surbone S, Malovini A. The effect of continuous positive airway pressure on pulmonary function may depend on the basal level of forced expiratory volume in 1 second. J Thorac Dis 2018; 10: 6819-27.
- Marin JM, Soriano JB, Carrizo SJ, Boldova A, Celli BR. Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med 2010; 182: 325-31.
- Abdeyrim A, Zhang Y, Li N, et al. 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.
- Graham BL, Teenbruggen I, Miller MR. Standardization of spirometry 2019 update an official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care MedVol 2019; 200: e70–e88.
- Berry RB, Brooks R, Gamaldo CE, et al. for the American Academy of Sleep Medicine. The AASM Manual for the scoring of sleep and associated events: rules, terminology, and technical specifications, Version2.3 2008 www.aasmnet.org. Darien, Illinois: American Academy of Sleep Medicine.
- Ramsey R, Mehra R, Strohl KP. Variations in physician interpretation of overnight pulse-oximetry monitoring.Chest 2007; 132: 852-9.
- Kushida CA, Chediak A, Berry RB, et al. Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnoea. Positive Airway Pressure Titration Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2008; 4: 157-71.
- Shawon MS, Perret JL, Senaratna CV, Lodge C, Hamilton GS, Dharmage SC. Current evidence on prevalence and clinical outcomes of co-morbid obstructive sleep apnea and chronic obstructive pulmonary disease: a systematic review. Sleep Med Rev 2017; 32: 58–68
- Lacedonia D, Carpagnano GE, Aliani M,et al. Daytime PaO2 in OSAS, COPD and the combination of the two (overlap syndrome). RespirMed 2013; 107: 310-6.
- Kuklisova Z, Tkacova R, Joppa P, Wouters E, Sastry M. Severity of nocturnal hypoxia and daytime hypercapnia predicts CPAP failure in patients with COPD and obstructive sleep apnea overlap syndrome. Sleep Med 2017; 30: 139-45.
- Sanders MH, Newman AB, Haggerty CL, et al. for the Sleep Heart Health Study. Sleep and sleep disordered breathing in adults with predominantly mild obstructive airway disease. Am J Respir Crit Care Med 2003; 167: 7-14.
- Owens RL. Supplemental oxygen needs during sleep. Who benefits? Respir Care 2013; 58: 32-47.
- Makarawate P, Senthong V, Sawanyawisuth K. Cpap Pressure by Cpap Titration or Prediction Formula. J Sleep Disorders Ther 2013, 2: 4.
- Camacho M, Riaz M, Tahoori A, Certal V, Kushida CA. Mathematical equations to predict positive airway pressures for obstructive sleep apnea: a systematic review. Sleep Disord 2015; 2015: 293868.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Orijinal Makale |
| Yazarlar | |
| Proje Numarası | yok |
| Yayımlanma Tarihi | 17 Ocak 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 5 Sayı: 1 |
Üniversitelerarası Kurul (ÜAK) Eşdeğerliği: Ulakbim TR Dizin'de olan dergilerde yayımlanan makale [10 PUAN] ve 1a, b, c hariç uluslararası indekslerde (1d) olan dergilerde yayımlanan makale [5 PUAN]
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Not: Dergimiz WOS indeksli değildir ve bu nedenle Q olarak sınıflandırılmamıştır.
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