Negative Expiratory Pressure (NEP) Technique and Anthropometric Derived Indices as Surrogate Markers for Predicting Obstructive Sleep Apnea Syndrome (OSAS)
DOI:
https://doi.org/10.12974/2312-5470.2017.04.1Keywords:
Negative expiratory pressure, obstructive sleep apnea syndrome, apnea hypopnea index, expiratory flow limitation, anthropometric data.Abstract
Introduction: We wondered whether anthropometric, lung function, arterial blood gas (ABG), tidal volume (VT), and Negative Expiratory Pressure (NEP) Technique data could be utilized alone or collectively for predicting the presence of obstructive sleep apnea syndrome (OSAS).
Methods: Thirty-eight consecutive subjects (29% females) were referred for symptoms suggestive of OSAS. They had no respiratory or any other system failure. Anthropometric data, VT and lung function measurements were obtained. All subjects underwent overnight polysomnogaphy (PSG). They were also subjected to the NEP technique (-5 cm H2O) in seated and supine positions, specifically investigating the usefulness of known NEP-acquired indices (EFL %, ΔV %, V, NEP 0.5, V0.2%). PSG classified subjects according to Apnea/Hypopnea Index (AHI).
Results: Eleven patients had AHI<15, whilst 27 had AHI≥15. Only ΔV % and V,NEP0.5 correlated with AHI in both positions. A Multiple Linear Regression (MLR) model using V,NEP 0.5 in the seated position (V,NEP 0.5se), Neck Circumference (NC), arterial oxygen tension (Pa02), Expiratory Reserve Volume (ERV,% pred), improves AHI prediction (R2 adj =0,814).
Conclusions: V,NEP0.5, could identify moderate and severe OSAS in stable patients. MLR models using additional parameters substantially improve AHI prediction.
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