Ultrasonographic changes and impact factors of diaphragmatic function in patients with obstructive sleep apnea-hypopnea syndrome.

Publisher: Springer Country of Publication: Germany NLM ID: 9804161 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-1709 (Electronic) Linking ISSN: 15209512 NLM ISO Abbreviation: Sleep Breath Subsets: MEDLINE

Publication: 2005- : Heidelberg ; New York : Springer
Original Publication: Titisee-Neustadt, Germany : Druckbild GmbH,

Sleep Apnea, Obstructive*/physiopathology ; Sleep Apnea, Obstructive*/diagnostic imaging ; Diaphragm*/physiopathology ; Diaphragm*/diagnostic imaging ; Ultrasonography*; Humans ; Male ; Cross-Sectional Studies ; Female ; Middle Aged ; Adult ; Polysomnography

Purpose: Diaphragmatic impairment has been reported in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients. However, the risk factors of diaphragmatic dysfunction are unclear. This study was conducted to evaluate the diaphragmatic function and to investigate impact factors of ultrasonographic changes of the diaphragm in OSAHS patients.
Methods: This cross-sectional study recruited 150 snoring patients. All patients were divided into the control group (AHI < 5/h, n = 20), the mild-to-moderate OSAHS group (5/h ≤ AHI ≤ 30/h, n = 61), and the severe OSAHS group (AHI > 30/h, n = 69). Diaphragmatic thickness at function residual capacity (T FRC ) and total lung capacity (T TLC ) were measured by two-dimensional ultrasound, and the diaphragmatic excursion during tidal and deep breath was measured by M-mode ultrasound. The diaphragmatic thickening fraction (TF) was calculated. Spearman analysis and multiple linear stepwise regression analysis were conducted to analyze the impact factors of diaphragmatic function.
Results: T FRC in the control group, mild-to-moderate OSAHS group, and severe OSAHS group was 1.23 (1.10, 1.39) mm, 1.60 (1.43, 1.85) mm, and 1.90 (1.70, 2.25) mm; T TLC was 2.75 (2.53, 2.93) mm, 3.25 (2.90, 3.55) mm, and 3.60 (3.33, 3.90) mm, and TF was 119.23% (102.94, 155.97), 96.55% (74.34, 119.11), and 85.29% (60.68,101.22). There were across-group significant differences in T FRC , T TLC, and TF (P < 0.05). The oxygen desaturation index was the influencing factor of T FRC , T TLC, and TF (P < 0.05).
Conclusion: The diaphragm is thickened and diaphragmatic contractility is decreased in OSAHS patients. Nocturnal intermittent hypoxia is a risk factor for diaphragmatic hypertrophy and impaired diaphragmatic contractility.
(© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

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82070095 National Natural Science Foundation

Keywords: Diaphragm; Intermittent hypoxia; Obstructive sleep apnea; Ultrasound

Date Created: 20240227 Date Completed: 20240624 Latest Revision: 20240624

20240624

10.1007/s11325-024-03010-7

38413555