Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 13 , ISSUE 4 ( October-December, 2024 ) > List of Articles

Original Article

A Study to Analyze Lung Function, Respiratory Muscle Strength, and Functional Exercise Capacity in Obstructive Sleep Apnea Patients

Preethi Mohan, Sankaranarayanan Sridevi, Thillai Govindarajan Senthil kumar

Keywords : Apnea–hypopnea index, Exercise tolerance, Functional exercise capacity, Lung function, Obstructive sleep apnea, Respiratory muscles

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.

DOI: 10.5005/jp-journals-11010-1145

License: CC BY-NC 4.0

Published Online: 17-02-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

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.


PDF Share
  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. Gharibeh T, Mehra R. Obstructive sleep apnea syndrome: natural history, diagnosis, and emerging treatment options. Nat Sci Sleep 2010;2:233–235. DOI: 10.2147/NSS.S6844
  11. 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
  12. 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
  13. Dewan NA, Nieto FJ, Somers VK. Intermittent hypoxemia and OSA. Chest 2015;147(1):266–274. DOI: 10.1378/chest.14-0500
  14. 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
  15. 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
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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
  26. 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
  27. 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
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.