Pulmonary function in obese snorers with or without sleep apnea syndrome.
We evaluated pulmonary function abnormalities associated with the sleep apnea syndrome (SAS) in 170 habitual snorers without SAS (n = 62, apnea-hypopnea index [AHI] < 10 per hour of sleep), with moderately severe SAS (n = 56, 10 < or = AHI < 30) or with severe SAS (n = 52, AHI > or = 30). The three groups were similar regarding obesity (BMI approximately 30 kg.m-2) and smoking history (approximately 20 pack-years). Pulmonary function was assessed by spirometry, forced oscillation mechanics, and gas exchange studies. Forced expiratory flows decreased as the SAS severity increased (p < 0.001, p < 0.02, and p < 0.05 for FEF50, FEV1, and FEV1/VC, respectively). Multiple regression analysis showed that the correlation between FEV50 and the AHI persisted when smoking history was taken into account (p < 0.05), suggesting that SAS may be an independent risk factor for small airway disease. A highly significant correlation was found between specific respiratory conductance (sGrs) and the AHI (p < 0.0001). In a multiple regression analysis (p < 0.0001), variables that influenced sGrs were distal airway obstruction as assessed by FEV50 (p < 0.05), morphological upper airway abnormalities as assessed by cephalometric parameters (p < 0.02), and the AHI (p < 0.0005). SAS appears to be highly correlated to lower and upper airway obstruction, as demonstrated by a reduction in specific respiratory conductance, which adds to the increase in breathing load due to obesity.
Zerah-Lancner
F
F
Service de Physiologie-Explorations Fonctionnelles, INSERM U 296, Hôpital Henri Mondor, Créteil, France.
Lofaso
F
F
Coste
A
A
Ricolfi
F
F
Goldenberg
F
F
Harf
A
A
D000704:Analysis of Variance; D015992:Body Mass Index; D002508:Cephalometry / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000503:physiopathology*; D017286:Polysomnography / Q000706:statistics & numerical data; D012044:Regression Analysis; D012129:Respiratory Function Tests / Q000379:methods / Q000706:statistics & numerical data; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology*; D012913:Snoring / Q000175:diagnosis / Q000503:physiopathology*