Abstract

ORNELAS, Cristina et al. Relationship between obstructive lung diseases and obstructive sleep apnea syndrome. Rev Port Imunoalergologia [online]. 2019, vol.27, n.2, pp.115-125. ISSN 0871-9721.  https://doi.org/10.32932/rpia.2019.03.009.

Background: Obstructive sleep apnea (OSA) syndrome is very common and several studies have reported its highest prevalence in patients with chronic obstructive pulmonary diseases. Aim: To characterize the relationship between these two diseases in adults. Methodology: Prospective study including all patients referred to perform cardiorespiratory polygraphy and/or polysomnography for suspected OSA in Pulmonology Department of Hospital do Divino Espírito Santo de Ponta Delgada. All patients filled a questionnaire (evaluation of OSA, obstructive pulmonary diseases and comorbidities) and performed pulmonary function test (PFT). These results were then related to polygraphic study/polysomnography. Results: 55 patients were included. Main comorbidities were arterial hypertension, smoking, gastro-esophageal reflux, rhinitis/rhinosinusitis and obesity. Ten patients had known diagnosis of asthma and six of chronic obstructive pulmonary disease (COPD). Through PFT results and symptoms reported, we performed diagnosis of COPD in four patients, of asthma in two patients and of asthma-COPD overlap in one patient. Diagnosis of OSA was stablished in 38 patients (69%), with 15 (39%) presenting bronchial obstruction. We found a significant correlation between Apnea-Hypopnea Index (AHI) and diabetes and obesity, and between PFT and smoking, rhinitis/rhinosinusitis, diabetes, ischemic heart disease and complaints of snoring and morning tiredness. Conclusions: Although there was no statistically significant association between AHI and PFT results, we found that 39% of the patients with OSA’s diagnosis had chronic obstructive pulmonary disease. Bronchial obstruction was observed in 18% of the patients without a known diagnosis, which highlights a high frequency of underdiagnosed chronic obstructive respiratory disease. It is also important to emphasize comorbidities’ role, mainly obesity, smoking, rhinosinusitis and diabetes, in these chronic respiratory diseases.

Keywords : Apnea-hypopnea index; asthma; asthma-chronic obstructive pulmonary disease overlap; polysomnography; pulmonary disease; chronic obstructive; respiratory function test; sleep apnea; obstructive.

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