title: Is polysomnographic examination necessary for subjects with diaphragm pathologies?
abstract: OBJECTIVE
  While respiratory distress is accepted as the only indication for diaphragmatic plication surgery, sleep disorders have been underestimated. In this study, we aimed to detect the sleep disorders that accompany diaphragm pathologies. Specifically, the association of obstructive sleep apnea syndrome with diaphragm eventration and diaphragm paralysis was evaluated.
  
  
  METHODS
  This study was performed in Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital between 2014-2016. All patients had symptoms of obstructive sleep apnea (snoring and/or cessation of breath during sleep and/or daytime sleepiness) and underwent diaphragmatic plication via video-assisted mini-thoracotomy. Additionally, all patients underwent pre- and postoperative full-night polysomnography. Pre- and postoperative clinical findings, polysomnography results, Epworth sleepiness scale scores and pulmonary function test results were compared.
  
  
  RESULTS
  Twelve patients (7 males) with a mean age of 48 (range, 27-60) years and a mean body mass index of 25 (range, 20-30) kg/m2 were included in the study. Preoperative polysomnography showed obstructive sleep apnea syndrome in 9 of the 12 patients (75%), while 3 of the patients (25%) were regarded as normal. Postoperatively, patient complaints, apnea hypopnea indices, Epworth sleepiness scale scores and pulmonary function test results all demonstrated remarkable improvement.
  
  
  CONCLUSIONS
  All patients suffering from diaphragm pathologies with symptoms should undergo polysomnography, and patients diagnosed with obstructive sleep apnea syndrome should be operated on. In this way, long-term comorbidities of sleep disorders may be prevented.
authors.affiliation: Sureyyapasa Chest & Thoracic Surgery Training and Research Hospital, Chest Diseases, Istanbul, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Oruc
authors.affiliation: Sureyyapasa Chest & Thoracic Surgery Training and Research Hospital, Chest Diseases, Istanbul, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Sarac
authors.affiliation: Sureyyapasa Chest & Thoracic Surgery Training and Research Hospital, Chest Diseases, Istanbul, Turkey.
authors.forename: Gulgun Cetintas
authors.initials: GC
authors.lastname: Afsar
authors.affiliation: Sureyyapasa Chest & Thoracic Surgery Training and Research Hospital, Neurology, Istanbul, Turkey.
authors.forename: Ozgur Bilgin
authors.initials: OB
authors.lastname: Topcuoglu
authors.affiliation: Sureyyapasa Chest & Thoracic Surgery Training and Research Hospital, Thoracic Surgery, Istanbul, Turkey.
authors.forename: Serda
authors.initials: S
authors.lastname: Kanbur
authors.affiliation: Sureyyapasa Chest & Thoracic Surgery Training and Research Hospital, Thoracic Surgery, Istanbul, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Yalcinkaya
authors.affiliation: Sureyyapasa Chest & Thoracic Surgery Training and Research Hospital, Allergy and Immunology, Istanbul, Turkey.
authors.forename: Fatma Merve
authors.initials: FM
authors.lastname: Tepetam
authors.affiliation: Faculty of Medicine Dicle University, Chest Diseases, Diyarbakir, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Kirbas
mesh_terms: D000328:Adult; D003964:Diaphragm / Q000503:physiopathology*; D003965:Diaphragmatic Eventration / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods*; D011184:Postoperative Period; D057234:Preoperative Period; D012016:Reference Values; D015203:Reproducibility of Results; D012133:Respiratory Paralysis / Q000175:diagnosis / Q000503:physiopathology*; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D016683:Supine Position / Q000502:physiology; D014797:Vital Capacity / Q000502:physiology