Prevalence and analysis of respiratory and anthropometric parameters in patients with obstructive sleep apnea
Keywords:Obstructive sleep apnea syndrome; Sleep disorders; Epidemiology; Diagnosis; Complications.
Introduction: Obstructive sleep apnea is a condition characterized by frequent respiratory pauses lasting ≥ 10 seconds, accompanied by desaturation/reoxygenation cycles and repetitive arousals triggered by complete (apnea) or partial (hypopnea) cessation of airflow during sleep. Objective: To determine the prevalence and to assess the respiratory and anthropometric parameters of patients with obstructive sleep apnea in Vale do São Francisco area. Methods: This is a descriptive, cross-sectional study using secondary data collected from 466 patients between June 2015 and June 2017. Patients who underwent home polysomnography were included while those who did not perform the lung function test and/or failed to present a medical report were excluded. Results: Obstructive sleep apnea was observed in 79.2% (n = 126) of the patients enrolled. Cases with greater severity were observed in males and were more prevalent among those aged 60 years or above. Forced expiratory volume in 1 second (P = 0.006) and forced vital capacity (P = 0.001) decreased with increased obstructive sleep apnea severity. Significant correlations were observed between the severity of obstructive sleep apnea and age, body mass index and Apnea-Hypopnea Index, while pulmonary function variables presented a low negative correlation with obstructive sleep apnea severity. Conclusion: Greater severity of obstructive sleep apnea was more prevalent in males and the involvement of the pulmonary function was more pronounced in the groups with severe obstructive sleep apnea. Reductions in lung function were also found in this population, with negative linear correlations between ventilatory parameters and obstructive sleep apnea severity.
Aguiar, I. C., Freitas, W. R. J., Santos, I. R., Apostolico, N., Nacif, S. R., Urbano, J. J., Fonsêca, N. T., Thuler, F. R., Ilias, E. J., Kassab, P., LeitãoFilho, F. S., Laurino Neto, R. M., Malheiros, C. A., Insalaco, G., Donner, C. F., & Oliveira, L. V. (2014). Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial. Multidisciplinary Respiratory Medicine, 9(1), 43. https://doi.org/10.1186/2049-6958-9-43
Asker, S., Asker, M., Sarikaya, E., Sunnetcioglu, A., Aslan, M., & Demir, H. (2015). Oxidative stress parameters and their correlation with clinical, metabolic and polysomnographic parameters in severe obstructive sleep apnea syndrome. International Journal of Clinical and Experimental Medicine, 8(7), 11449–11455.
Barbosa, I. dos S., Souza, J. C., Muller, P. de T. G., Brito, P. O. C., Augusto, C. T., & Cantarelli, I. de A. C. (2021). Avaliação dos distúrbios do sono de pacientes submetidos à polissonografia. Research, Society and Development, 10(1), e40110111738. https://doi.org/10.33448/rsd-v10i1.11738
Canales, M. T., Hagen, E. W., Barnet, J. H., Peppard, P. E., & Derose, S. F. (2018). Sleep Apnea and kidney function trajectory: results from a 20-year longitudinal study of healthy middle-aged adults. Sleep, 41(1). https://doi.org/10.1093/sleep/zsx181
Capalbo, L. C., Dal-Fabbro, R., Donine, A. L. M. de A., Saraiva, J. S., Bigliazzi, R., Weber, S. A. T., & Bertoz, A. P. M. (2021). Rapid maxillary expansion as a treatment for obstructive sleep apnea syndrome in children and adolescents: an evaluation by polysomnography and quality of life. Research, Society and Development, 10(2), e52710212825. https://doi.org/10.33448/rsd-v10i2.12825
Carvalho, L. P. da C., Gomes, M. B. da C., Oliveira, Í. C. da S., Santos, P. H. S., De Oliveira II, A. C., Vitavar, L. M. G., & Alves, H. B. (2020). Responses of myokines concentrations from exercise stimulus: a systematic review. Revista Brasileira de Fisiologia Do Exercício, 19(5), 421. https://doi.org/10.33233/rbfex.v19i5.4393
Carvalho, T. M. da C. S., Soares, A. F., Climaco, D. C. S., Secundo, I. V., & Lima, A. M. J. de. (2018). Correlation of lung function and respiratory muscle strength with functional exercise capacity in obese individuals with obstructive sleep apnea syndrome. Jornal Brasileiro de Pneumologia, 44(4), 279–284. https://doi.org/10.1590/s1806-37562017000000031
Caspersen, N. F., Røsjø, H., Flyvbjerg, A., Bjerre, M., Randby, A., Hrubos-strøm, H., Omland, T., & Einvik, G. (2018). The association between circulating adiponectin levels, lung function and adiposity in subjects from the general population; data from the Akershus Sleep Apnea Project. BMC Pulmonary Medicine; 18, 54. https://doi.org/10.1186/s12890-018-0618-4
Chen, V. G., Fonseca, V. M. G. da, Amaral, J. B., Camargo-Kosugi, C. M., Moreira, G., Kosugi, E. M., & Fujita, R. R. (2020). Inflammatory markers in palatine tonsils of children with obstructive sleep apnea syndrome. Brazilian Journal of Otorhinolaryngology, 86(1), 23–29. https://doi.org/10.1016/j.bjorl.2018.08.001
Cunha, T. C. A., Guimarães, T. M., Almeida, F. R., Haddad, F. L. M., Godoy, L. B. M., Cunha, T. M., Silva, L. O., Tufik, S., & Bittencourt, L. (2020). Using craniofacial characteristics to predict optimum airway pressure in obstructive sleep apnea treatment. Brazilian Journal of Otorhinolaryngology, 86(2), 174–179. https://doi.org/10.1016/j.bjorl.2018.10.012
Da Cruz Carvalho, L. P., De Souza, S. S. N., Souza, D. C., Araujo, F. D. S., Carvalho, F. O., De Moraes, J. F. V. N., & Gomes, J. L. D. B. (2020). Analysis of glycemic safety of a moderate-intensity resistance exercise session in patients with diabetes type 1. Revista Brasileira de Fisiologia do Exercício, 19(1), 16. https://doi.org/10.33233/rbfe.v19i1.3905
Degache, F., Sforza, E., Dauphinot, V., Celle, S., Garcin, A., Collet, P., Pichot, V., Barthélémy, J.-C., & Roche, F. (2013). Relation of central fat mass to obstructive sleep apnea in the elderly. Sleep, 36(4), 501–507. https://doi.org/10.5665/sleep.2532
Drager, L. F., Togeiro, S. M., Polotsky, V. Y., & Lorenzi-Filho, G. (2013). Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome. Journal of the American College of Cardiology, 62(7), 569–576. https://doi.org/10.1016/j.jacc.2013.05.045
Edwards, B. A., Wellman, A., Sands, S. A., Owens, R. L., Eckert, D. J., White, D. P., & Malhotra, A. (2014). Obstructive sleep apnea in older adults is a distinctly different physiological phenotype. Sleep, 37(7), 1227–1236. https://doi.org/10.5665/sleep.3844
Franklin, K. A., & Lindberg, E. (2015). Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. Journal of Thoracic Disease, 7(8), 1311–1322. https://doi.org/10.3978/j.issn.2072-1439.2015.06.11
Gabbay, I. E., & Lavie, P. (2012). Age- and gender-related characteristics of obstructive sleep apnea. Sleep & Breathing, 16(2), 453–460. https://doi.org/10.1007/s11325-011-0523-z
Gautier-Veyret, E., Bäck, M., Arnaud, C., Belaïdi, E., Tamisier, R., Lévy, P., Arnol, N., Perrin, M., Pépin, J. L., & Stanke-Labesque, F. (2018). Cysteinyl-leukotriene pathway as a new therapeutic target for the treatment of atherosclerosis related to obstructive sleep apnea syndrome. Pharmacological Research, 134, 311–319. https://doi.org/10.1016/j.phrs.2018.06.014
Genta, P. R., Schorr, F., Edwards, B. A., Wellman, A., & Lorenzi-Filho, G. (2020). Discriminating the severity of pharyngeal collapsibility in men using anthropometric and polysomnographic indices. Journal of Clinical Sleep Medicine, 16(9), 1531–1537. https://doi.org/10.5664/jcsm.8600
Gottlieb, D. J., & Punjabi, N. M. (2020). Diagnosis and Management of obstructive sleep apnea. JAMA, 323(14), 1389. https://doi.org/10.1001/jama.2020.3514
Heinzer, R., Vat, S., Marques-Vidal, P., Marti-Soler, H., Andries, D., Tobback, N., Mooser, V., Preisig, M., Malhotra, A., Waeber, G., Vollenweider, P., Tafti, M., & Haba-Rubio, J. (2015). Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. The Lancet Respiratory Medicine, 3(4), 310–318. https://doi.org/10.1016/S2213-2600(15)00043-0
Jean-Louis, G., Zizi, F., Brown, D., Ogedegbe, G., Borer, J., & McFarlane, S. (2009). Obstructive sleep apnea and cardiovascular disease: evidence and underlying mechanisms. Minerva Pneumologica, 48(4), 277–293.
Jehan, S., Myers, A. K., Zizi, F., Pandi-Perumal, S. R., Jean-Louis, G., & McFarlane, S. I. (2018). Obesity, obstructive sleep apnea and type 2 diabetes mellitus: Epidemiology and pathophysiologic insights. Sleep Medicine and Disorders, 2(3), 52–58.
Liu, W.-T., Wu, H., Juang, J.-N., Wisniewski, A., Lee, H.-C., Wu, D., & Lo, Y.-L. (2017). Prediction of the severity of obstructive sleep apnea by anthropometric features via support vector machine. PLOS ONE, 12(5), e0176991. https://doi.org/10.1371/journal.pone.0176991
Maresky, H. S., Klar, M. M., Tepper, J., Gavriel, H., Ziv Baran, T., Shapiro, C. M., & Tal, S. (2019). Mandibular width as a novel anthropometric measure for assessing obstructive sleep apnea risk. Medicine, 98(4), e14040. https://doi.org/10.1097/MD.0000000000014040
Masserini, B., Morpurgo, P. S., Donadio, F., Baldessari, C., Bossi, R., Beck-Peccoz, P., & Orsi, E. (2006). Reduced levels of adiponectin in sleep apnea syndrome. Journal of Endocrinological Investigation, 29(8), 700–705. https://doi.org/10.1007/BF03344179
Mazzotti, D. R., Keenan, B. T., Lim, D. C., Gottlieb, D. J., Kim, J., & Pack, A. I. (2019). Symptom Subtypes of obstructive sleep apnea predict incidence of cardiovascular outcomes. American Journal of Respiratory and Critical Care Medicine, 200(4), 493–506. https://doi.org/10.1164/rccm.201808-1509OC
Modena, D. A. O., Cazzo, E., Cândido, E. C., Baltieri, L., Silveira, L. J. B. da, Almeida, A. M. N. de, Gobato, R. C., & Chaim, E. A. (2017). Obstructive sleep apnea syndrome among obese individuals: A cross-sectional study. Revista da Associação Médica Brasileira, 63(10), 862–868. https://doi.org/10.1590/1806-9222.214.171.1242
Osman, A. M., Carter, S. G., Carberry, J. C., & Eckert, D. J. (2018). Obstructive sleep apnea: current perspectives. Nature and Science of Sleep, 10, 21–34. https://doi.org/10.2147/NSS.S124657
Patil, S. P., Ayappa, I. A., Caples, S. M., Kimoff, R. J., Patel, S. R., & Harrod, C. G. (2019). Treatment of adult obstructive sleep apnea with positive airway pressure: an american academy of sleep medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 15(02), 335–343. https://doi.org/10.5664/jcsm.7640
Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177(9), 1006–1014. https://doi.org/10.1093/aje/kws342
Qian, Y., Xu, H., Wang, Y., Yi, H., Guan, J., & Yin, S. (2016). Obstructive sleep apnea predicts risk of metabolic syndrome independently of obesity: a meta-analysis. Archives of Medical Science, 12(5), 1077–1087. https://doi.org/10.5114/aoms.2016.61914
Reutrakul, S., & Mokhlesi, B. (2017). Obstructive sleep apnea and diabetes. Chest, 152(5), 1070–1086. https://doi.org/10.1016/j.chest.2017.05.009
Souto, V. F., Da Silva, C. A., Lins, N. C. de M., Araújo, M. L. D., & Costa, A. D. S. (2020). Impact of dietary composition and resistance training on cardiovascular risk indicators and abdominal fat in older adult women. Revista Brasileira de Fisiologia do Exercício, 19(6), 489. https://doi.org/10.33233/rbfex.v19i6.4280
Sreedharan, S., Agrawal, P., Rajith, R., Nair, S., Sarma, S., & Radhakrishnan, A. (2016). Clinical and polysomnographic predictors of severe obstructive sleep apnea in the South Indian population. Annals of Indian Academy of Neurology, 19(2), 216–220. https://doi.org/10.4103/0972-2327.173315
Sun, S., Zhai, H., Zhu, M., Wen, P., He, X., & Wang, H. (2019). Insulin resistance is associated with Sfrp5 in obstructive sleep apnea. Brazilian Journal of Otorhinolaryngology, 85(6), 739–745. https://doi.org/10.1016/j.bjorl.2018.07.002
Sweed, R. A., Hassan, S., ElWahab, N. H. A., Aref, S. R., & Mahmoud, M. I. (2019). Comorbidities associated with obstructive sleep apnea: a retrospective Egyptian study on 244 patients. Sleep and Breathing, 23(4), 1079–1085. https://doi.org/10.1007/s11325-019-01783-w
Tichanon, P., Wilaiwan, K., Sopida, S., Orapin, P., Watchara, B., & Banjamas, I. (2016). Effect of Continuous positive airway pressure on airway inflammation and oxidative stress in patients with obstructive sleep apnea. Canadian Respiratory Journal, 2016, 3107324. https://doi.org/10.1155/2016/3107324
Veasey, S. C., & Rosen, I. M. (2019). Obstructive sleep apnea in adults. New England Journal of Medicine, 380(15), 1442–1449. https://doi.org/10.1056/NEJMcp1816152
Vukoja, M., Milicic, D., Bokan, A., Andrijevic, I., & Kopitovic, I. (2017). Lung function in patients with obstructive sleep apnoea. ERJ Open Research, 3(Suppl 1), P14. https://doi.org/10.1183/23120541.sleepandbreathing-2017.P14
Wali, S. O., Abalkhail, B., & Krayem, A. (2017). Prevalence and risk factors of obstructive sleep apnea syndrome in a Saudi Arabian population. Annals of Thoracic Medicine, 12(2), 88–94. https://doi.org/10.4103/1817-1737.203746
Yamauchi, M., Nakano, H., Maekawa, J., Okamoto, Y., Ohnishi, Y., Suzuki, T., & Kimura, H. (2005). Oxidative stress in obstructive sleep apnea. Chest, 127(5), 1674–1679. https://doi.org/10.1378/chest.127.5.1674
Zeng, F., Wang, X., Hu, W., & Wang, L. (2017). Association of adiponectin level and obstructive sleep apnea prevalence in obese subjects. Medicine, 96(32), e7784. https://doi.org/10.1097/MD.0000000000007784
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Copyright (c) 2021 Danilo Sobral da Silva Fernandes; Manoel Pereira Guimarães; Einstein Zeus Alves de Brito; João Diego Cabral Lima; Mateus de Sousa Rodrigues; Victor Ribeiro Neves; Bruno Bavaresco Gambassi; Paulo Adriano Schwingel; Fabrício Olinda de Souza Mesquita
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