Citation Information :
Mohan P, Sridevi S, kumar TG. A Study to Analyze Lung Function, Respiratory Muscle Strength, and Functional Exercise Capacity in Obstructive Sleep Apnea Patients. Indian J Respir Care 2024; 13 (4):248-252.
Introduction: Obstructive sleep apnea (OSA) is characterized by recurrent airway obstructions, resulting in decreased oxygen levels and disrupted sleep. These episodes can manifest as hypopnea or apnea, affecting respiratory muscle function, lung capacity, and chest compliance. OSA significantly impacts exercise tolerance and aerobic capacity, with severity influencing these limitations.
Aim: This study aims to evaluate lung function, respiratory muscle strength (RMS), and functional exercise capacity (FEC) and to investigate how various factors affect respiratory parameters and FEC in individuals with OSA.
Methods: The study included 30 patients aged 18–80 years, of both genders, diagnosed with OSA and chronic obstructive pulmonary disease. Those with significant cardiopulmonary, neuromuscular, or orthopedic disorders affecting functional capacity were excluded. Lung function was measured using a Medical International Research (MIR) Spirometer for forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and the FEV1/FVC ratio, while RMS was assessed with a manovacuometer for maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). FEC was determined using the six-minute walk test.
Results: The mean values for FVC, FEV1, and the FEV1/FVC ratio were 1.44 (0.51), 1.29 (0.42), and 92.87 (7.08), respectively. The mean distance covered in the six-minute walk test was 92.35 (52.53). There was a positive correlation in RMS and a positive relationship between lung function and FEC in patients with OSA.
Conclusion: The findings indicate a decline in lung function, RMS, and functional capacity in OSA patients.
Huang JF, Chen LD, Lin QC, et al. The relationship between excessive daytime sleepiness and metabolic syndrome in severe obstructive sleep apnea syndrome. Clin Respir J 2016;10(6):714–721. DOI: 10.1111/crj.12276
Hsia JC. Anatomy and physiology of the upper airway in obstructive sleep apnea. Oper Tech Otolayngol Head Neck Surg 2015;26(2):74–77. DOI: 10.1016/j.otot.2015.03.005
Huang L, Gao X. The interaction of obesity and craniofacial deformity in obstructive sleep apnea. Dentomaxillofac Radiol 2021;50(4):20200425. DOI: 10.1259/dmfr.20200425
Martins AB, Tufik S, Moura SMGPT. Síndrome da apnéia-hipopnéia obstrutiva do sono. Fisiopatologia. Jornal Brasileiro de Pneumologia 2007;33(1):93–100. DOI: 10.1590/S1806-37132007000100017
Melo LC, da Silva MAM, Calles ACN. Obesity and lung function: a systematic review. Einstein(Sao Paulo) 2014;12(1):120–125. DOI: 10.1590/s1679-45082014rw2691
Yokhana SS, Gerst DG, Lee DS, et al. Impact of repeated daily exposure to intermittent hypoxia and mild sustained hypercapnia on apnea severity. J Appl Physiol 2012;112(3):367–377. DOI: 10.1152/japplphysiol.00702.2011
Mateika JH, Syed Z. Intermittent hypoxia, respiratory plasticity and sleep apnea in humans: present knowledge and future investigations. Respir Physiol Neurobiol 2013;188(3):289–300. DOI: 10.1016/j.resp.2013.04.010
Ruehland WR, Rochford PD, O'Donoghue FJ, et al. The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. Sleep 2009;32(2):150–157. DOI: 10.1093/sleep/32.2.150
Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018;12(9):755–767. DOI: 10.1080/17476348.2018.1506331
Stavrou VT, Astara K, Karetsi E, et al. Respiratory muscle strength as an indicator of the severity of the apnea-hypopnea index: stepping towards the distinction between sleep apnea and breath holding. Cureus 2021;13(3):e14015. DOI: 10.7759/cureus.14015
Vanuxem D, Badier M, Guillot C, et al. Impairment of muscle energy metabolism in patients with sleep apnoea syndrome. Respir Med 1997;91(9):551–557. DOI: 10.1016/s0954-6111(97)90089-5
Dewan NA, Nieto FJ, Somers VK. Intermittent hypoxemia and OSA. Chest 2015;147(1):266–274. DOI: 10.1378/chest.14-0500
Pinto A, Devaraj U, Ramachandran P, et al. Obstructive sleep apnea in a rural population in South India: feasibility of health care workers to administer level III sleep study. Lung India 2018;35(4):301–306. DOI: 10.4103/lungindia.lungindia_433_17
Buysse DJ, Reynolds CF, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193–213. DOI: 10.1016/0165-1781(89)90047-4
Silveira BMF, Pereira MCB, Cardoso DR, et al. New method for evaluating maximal respiratory pressures: concurrent validity, test-retest, and inter-rater reliability. Braz J Phys Ther 2021;25(6):741–748. DOI: 10.1016/j.bjpt.2021.04.012
Nanthakumar S, Bucks RS, Skinner TC, et al. Assessment of the Depression, Anxiety, and Stress Scale (DASS-21) in untreated obstructive sleep apnea (OSA). Psychol Assess 2017;29(10):1201–1209. DOI: 10.1037/pas0000401
Zhou P, Yang L, Huang YX. A smart phone based handheld wireless spirometer with functions and precision comparable to laboratory spirometers. Sensors (Basel) 2019;19(11):2487. DOI: 10.3390/s19112487
Manca A, Fiorito G, Morrone M, et al. A novel estimate of biological aging by multiple fitness tests is associated with risk scores for age-related diseases. Front Physiol 2023;14:1164943. DOI: 10.3389/fphys.2023.1164943
Beitler JR, Awad KM, Bakker JP, et al. Obstructive sleep apnea is associated with impaired exercise capacity: a cross-sectional study. J Clin Sleep Med 2014;10(11):1199–204. DOI: 10.5664/jcsm.4200
Bradley TD, Brown IG, Grossman RF, et al. Pharyngeal size in snorers, nonsnorers, and patients with obstructive sleep apnea. N Engl J Med 1986;315(21):1327–1331. DOI: 10.1056/NEJM198611203152105
Hoffstein V, Zamel N, Phillipson EA. Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnea. Am RevRespir Dis 1984;130(2):175–178. DOI: 10.1164/arrd.1984.130.2.175
Spicuzza L, Caruso D, Di Maria G. Obstructive sleep apnoea syndrome and its management. Ther Adv Chronic Dis 2015;6(5):273–285. DOI: 10.1177/2040622315590318
Heinzer RC, ML, A, et al. Effect of increased lung volume on sleep disordered breathing in patients with sleep apnoea. Thorax 2006;61(5):435–439. DOI: 10.1136/thx.2005.052084
Dempsey JA, Veasey SC, Morgan BJ, et al. Pathophysiology of sleep apnea. Physiol Rev 2010;90(1):47–112. DOI: 10.1152/physrev.00043.2008
Iftikhar IH, Kline CE, Youngstedt SD. Effects of exercise training on sleep apnea: a meta-analysis. Lung 2014;192(1):175–184. DOI: 10.1007/s00408-013-9511-3
Quan SF, O'Connor GT, Quan JS, et al. Association of physical activity with sleep-disordered breathing. SleepBreath 2007;11(3):149–157. DOI: 10.1007/s11325-006-0095-5