Role of IOS in Assessing the Improvement of Obstructive Component in Moderate to Severe Obstructive Sleep Apnea Hypopnea Syndrome
Ravi Dosi, Priyanshu Jain, Arpit Jain, Satish Motiwale, Prakash Joshi
IOS, NIV, OSAHS, Spirometry.
Citation Information :
Dosi R, Jain P, Jain A, Motiwale S, Joshi P. Role of IOS in Assessing the Improvement of Obstructive Component in Moderate to Severe Obstructive Sleep Apnea Hypopnea Syndrome. Indian Sleep Med 2018; 13 (2):25-28.
Introduction: Impulse oscillometry (IOS), a simple, noninvasive method using the forced oscillation technique, requires minimal patient cooperation and is suitable for use in both children and adults. This method can be used to assess obstruction in the large and small peripheral airways.
Aim: To study impulse oscillometry measurements in cases of moderate to severe sleep apnea.
Materials and Methods: A study was performed in Department of Respiratory Medicine, Sri Aurobindo Institute of Medical Sciences. Thirty patients diagnosed with severe sleep apnea underwent home noninvasive ventilation therapy. Pre- and post treatment noninvasive ventilation (NIV) impulse oscillometry was given to these patients.
Results: The pre-NIV spirometry showed predominant mixed pattern of disease with Impulse oscillometry showing reduced R25 and R5 levels. Post 3 months of noninvasive ventilation therapy with > 80% compliance demonstrated improvement in R25 parameters.
Conclusion: Respiratory resistance and reactance measured by Impulse oscillometryare abnormal in preobese and obese obstructive sleep apnea hypopnea syndrome (OSAHS) patients, and these parameters are closely correlated with OSAHS severity. Impulse oscillometrymight be a useful screening tool for detecting OSAHS in clinic based populations.
Stanchina ML, Malhotra A, Fogel RB, Trinder J, Edwards JK, Schory K, White DP. The influence of lung volume on pharyngeal mechanics, collapsibility, and genioglossus muscle activation during sleep. Sleep. 2003 Oct 1;26(7):851–856.
Bijaoui EL, Champagne V, Baconnier PF, Kimoff RJ, Bates HT. Mechanical properties of the lung and upper airways in patients with sleep-disordered breathing. Am J Respir Crit Care Med. 2002;165:1055–1061.
Bijaoui EL, Champagne V, Baconnier PF, Kimoff RJ, Bates J. Mechanical properties of the lung and upper airways in patients with sleep-disordered breathing. American journal of respiratory and critical care medicine. 2002 Apr 15;165(8):1055-61.
Morgan BJ, Reichmuth KJ, Peppard PE, Finn L, Barczi SR, Young T, Nieto FJ. Effects of sleep-disordered breathing on cerebrovascular regulation: a population-based study. American journal of respiratory and critical care medicine. 2010 Dec 1;182(11):1445-52.
Yaggi HK, Concato J, Kernan WN, Licntman JH, Brass LM, Mohsemin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005 Nov;353:2034– 2041.
Verin E, Tardif C, Portier F, Similowski T, Pasquis P, Muir JF. Evidence for expiratory flow limitation of extrathoracic origin in patients with obstructive sleep apnoea. Thorax. 2002 May 1;57(5):423–428.
Van Meerhaeghe A, Delpire P, Stenuit P, Kerkofs N. Operating characteristics of the negative expiratory pressure technique in predicting obstructive sleep apnoea syndrome in snoring patients. Thorax. 2004;59(10):883–888.
Van Noord JA, Wellens W, Clarysse I, Cauperghs M, Vande Woestijne KP, Demedts MG. Total respiratory resistance and reactance in patients with upper airway obstruction. Chest. 1987 Sep;92(3):475–480.
Owens RL, Malhotra A, Eckert DJ, White DP, Jordan AS. The influence of end-expiratory lung volume on measurements of pharyngeal collapsibility. J Appl Physiol. 2010 Feb;108(2):445–451.
Tagaito Y, Isono S, Remmers JE, Tanaka A, Nishino T. Lung volume and collapsibility of the passive pharynx in patients with sleep-disordered breathing. J Appl Physiol. 2007 Oct;103(4):1379–1385.
Lorino AM, Hamoudi K, Lofaso F, Dahan E, Mariette C, Harf A, Lorino H. Effects of continuous negative airway pressure on lung volume and respiratory resistance. J Appl Physiol. 1999 Aug 1;87(2):605–610. [PubMed]
Abdeyrim A, Zhang YP, Li NF, Zhao MH, Wang YH, Yao XU. Impact of obstructive sleep apnea on lung volumes and mechanical properties of the respiratory system in overweight and obese individuals. BMC Pulmonary Medicine. 2015;15:76.
American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3. Darien, IL: American Academy of Sleep Medicine; 2014.
Oostveen E, MacLeod D, Lorino H, Farre R, Hantos Z, Desager K, Marchal F. The forced oscillation technique in clinical practice:methodology, recommendations and future developments. EurRespir J. 2003 Dec 1;22(6):1026–1041.
Suratt PM, Wilhoit SC, Hsiao HS, Atkinson RL, Rochester DF. Compliance of chest wall in obese subjects. J Appl Physiol. 1984 Aug 1;57(2):403–407. [PubMed]
Pelosi P, Croci M, Ravagnan I, Vicardi P, Gattinoni L. Total respiratory system, lung, and chest wall mechanics in sedated-paralyzed postoperative morbidly obese patients. Chest. 1996 Jan 1;109(1):144–151.
Behazin N, Jones SB, Cohen RI, Loring SH. Respiratory restriction and elevated pleural and esophageal pressures in morbid obesity. J Appl Physiol. 2009 Nov 12;108(1):212– 218.