Silva Sidney Fernandes da, Santos Carlos Eduardo, Fonseca Iasmim Maria Pereira Pinto, Pereira Wellington de Oliveira, Anjos Hendyl Pereira Soares Dos, Lopes Agnaldo José
Rehabilitation Sciences Postgraduation Program, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ, Brazil.
School of Physiotherapy, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, RJ, Brazil.
Sleep Sci. 2024 Aug 14;18(2):e138-e146. doi: 10.1055/s-0044-1789188. eCollection 2025 Jun.
The present study aimed to compare the risk of developing sleep disorders with abnormalities in lung mechanics, abnormal ultrasound signals, and anthropometric parameters in adults with obesity. A total of 50 individuals were assessed for the risk of obstructive sleep apnea (OSA) using the Mallampati classification, the Epworth Sleepiness Scale (ESS), the Snoring, Tiredness, Observed Apnea, High Blood Pressure, Body Mass Index, Age, Neck Circumference, and Gender (STOP-Bang) questionnaire, and the Sleep Apnea Clinical Score (SACS). Patients also underwent respiratory oscillometry, spirometry, and thoracic ultrasound. The subgroup with abnormal respiratory oscillometry was more likely to have an ESS score indicating a high risk of developing OSA (87.5%) than the subgroup with normal respiratory oscillometry (42.9%) ( = 0.024). On thoracic ultrasound, the frequency of patients with a Mallampati classification of high risk of developing OSA was greater in the subgroup with > 2 B-lines (80%) than in the subgroup with ≤ 2 B-lines (25.7%) ( = 0.0003). The subgroup with subpleural consolidations was more likely to have an OSA-indicative ESS score (100%) than the subgroup without subpleural consolidations (41.9%) ( = 0.004). According to the multivariate analysis, > 2 B lines and body mass index were found to be independent variables for predicting the Mallampati classification, while subpleural consolidation was the only independent variable for predicting the ESS score. In adults with obesity, the greater the risk of developing OSA was, the worse the resistive and reactive parameters measured by respiratory oscillometry. Abnormal respiratory oscillometry and abnormal thoracic ultrasound are factors associated with a high risk of developing OSA.
本研究旨在比较肥胖成年人中出现睡眠障碍的风险与肺力学异常、超声信号异常和人体测量参数之间的关系。 共有50名个体使用马兰帕蒂分类法、爱泼华嗜睡量表(ESS)、打鼾、疲劳、观察到的呼吸暂停、高血压、体重指数、年龄、颈围和性别(STOP-Bang)问卷以及睡眠呼吸暂停临床评分(SACS)对阻塞性睡眠呼吸暂停(OSA)风险进行评估。患者还接受了呼吸振荡测定法、肺量计检查和胸部超声检查。 与呼吸振荡测定正常的亚组(42.9%)相比,呼吸振荡测定异常的亚组更有可能出现提示发生OSA高风险的ESS评分(87.5%)(P = 0.024)。在胸部超声检查中,马兰帕蒂分类提示发生OSA高风险的患者频率在B线>2条的亚组(80%)中高于B线≤2条的亚组(25.7%)(P = 0.0003)。与无胸膜下实变的亚组(41.9%)相比,有胸膜下实变的亚组更有可能出现提示OSA的ESS评分(100%)(P = 0.004)。根据多变量分析,发现>2条B线和体重指数是预测马兰帕蒂分类的独立变量,而胸膜下实变是预测ESS评分的唯一独立变量。 在肥胖成年人中,发生OSA的风险越高,通过呼吸振荡测定法测得的阻力和反应性参数就越差。呼吸振荡测定异常和胸部超声异常是与发生OSA高风险相关的因素。