Supervisors info:
Σπυρίδων Ζακυνθινός, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Σπυρίδων Μεντζελόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Εμμανουήλ Βαγιάκης, Διευθυντής Ε.Σ.Υ., Υπ. Εργ. Ύπνου, Γ.Ν.Α. "Ο Ευαγγελισμός"
Original Title:
Ανασκόπηση βιβλιογραφίας για δείκτες που προκύπτουν από το λειτουργικό έλεγχο της αναπνοής του εξεταζόμενου ασθενούς και τις δοκιμασίες εκτίμησης της παρουσίας φλεγμονής στους ανώτερους αεραγωγούς, που να συσχετίζονται με τη διάγνωση συνδρόμου αποφρακτικής υπνικής άπνοιας
Summary:
Obstructive sleep apnea is a common breathing sleep disorder, that is characterized by repetitive upper airway narrowing or collapse during sleep. Pulmonary function tests reflect the physiological properties of the lungs, e.g. airflow mechanics, volumes and gas transfer. These tests have been used to predict, diagnose and monitor lung disease as well as to help clinicians explain patient’s symptoms. The purpose of this study was to reveal the relationship between pulmonary function tests parameters and obstructive sleep apnea, aiming to the use of those parameters as predictive factors for the diagnosis of OSA.
RESULTS: According to current data forced expiratory flows (FEF50, FEF25 and maximum forced expiratory flow during the middle half of the FVC-MEF25-75), assessed by spirometry, are decreased in patients with obstructive sleep apnea. Functional residual capacity (FRC) and expiratory reserve volume(ERV) are also significantly decreased in OSA. The aforementioned parameters are shown to be further decreased as the severity of obstructive sleep apnea increases. Respiratory mechanical properties, such as lung elasticity, airway and chest wall resistance, can be well assessed by the impulse oscillation system. Respiratory resistance measured at low frequencies (Rrs5%), which reflects the small peripheral airways resistance, is significantly increased(Rrs5% 120 vs 104, p=0,01), whereas respiratory conductance (Grs) is significantly decreased among OSA patients(Grs 2,26 vs 2,78 L/s/kPa, p<0,001). Additionally, airway inflammation which is a common finding in patients with obstructive sleep apnea, can be assessed by measuring the biomarker fractional exhaled nitric oxide (FeNO). Studies have shown that patients with moderate-severe OSA had significantly higher FeNO counts than patients with no-or-mild OSA(18.40 ± 9.20 vs. 31.30 ± 13.60 ppb, p < 0.05).
CONCLUSION: Obstructive sleep apnea is highly correlated with alterations of respiratory mechanical properties at the time of diagnosis. This study indicated that relationships exist between pulmonary function tests parameters, FeNO counts and obstructive sleep apnea. These parameters and biomarkers could be used as predictive factors indicating OSA in the future.
Keywords:
Obstructive sleep apnea, Pulmonary function tests, Spirometry, Impulse oscillometry, Feno
