The use of handheld nasal spirometry to predict the presence of obstructive sleep apnea

Objective Nasal obstruction and oral breathing may play an important role in the pathophysiology of obstructive sleep apnea (OSA). This study aims to better understand the link between oral breathing, nasal obstruction, and the spectrum of sleep-disordered breathing. Study Design Prospective study....

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Bibliographic Details
Published in:Sleep & breathing 2018-03, Vol.22 (1), p.79-84
Main Authors: Fastenberg, Judd H., Fang, Christina H., Patel, Viraj M., Lin, Juan, Stupak, Howard D.
Format: Article
Language:English
Subjects:
Adult
Aged
Apnea
Dentistry
Humans
Internal Medicine
Medicine
Medicine & Public Health
Middle Aged
Neurology
Nose
Otorhinolaryngology
Pediatrics
Pneumology/Respiratory System
Polysomnography
Prospective Studies
Respiration
Sleep
Sleep apnea
Sleep Apnea, Obstructive - diagnosis
Sleep Apnea, Obstructive - physiopathology
Sleep Breathing Physiology and Disorders • Original Article
Sleep disorders
Spirometry
Spirometry - instrumentation
Young Adult
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Summary:Objective Nasal obstruction and oral breathing may play an important role in the pathophysiology of obstructive sleep apnea (OSA). This study aims to better understand the link between oral breathing, nasal obstruction, and the spectrum of sleep-disordered breathing. Study Design Prospective study. Methods and materials Prospective study of patients who presented to the Otolaryngology clinic and underwent polysomnogram (PSG) from 2015 to 2016. Patients were divided into two groups based on the severity of their OSA as defined by PSG results. Both apnea-hypopnea index (AHI) and supine and REM AHI (SUP-REMe AHI), a parameter that takes into account both sleep position and sleep stage, were recorded. The primary outcome was awake nasal-oral forced expiratory volume in 1-s (FEV1) ratio as measured by handheld spirometry. Results A total of 21 patients were included in the study. We found that nasal-oral FEV1 ratio was significantly different between patients with minimal and substantial OSA as stratified by SUP-REMe AHI, while not significant when stratified by AHI. Conclusion Patients with substantial OSA as determined by SUP-REMe AHI are more likely to have decreased awake nasal airflow as measured by nasal-oral FEV1. SUP-REMe AHI may represent an improved metric of OSA severity by taking into account sleep position and sleep stage. Handheld spirometers have the potential to become an important office tool by allowing for easy and reliable measurement of nasal airflow.
ISSN:1520-9512
1522-1709
DOI:10.1007/s11325-017-1531-4