Obstructive sleep apnoea and lung function, and their association with nocturnal hypoxemia: results from the Swedish CArdioPulmonary bioimage Study (SCAPIS) – a cross-sectional study

• Published in: BMJ open Vol. 14; no. 11; p. e086596
• Main Authors: Delshad, Baz, Ljunggren, Mirjam, Zhou, Xing Wu, Theorell-Haglöw, J, Janson, Christer, Zou, Ding, Hedner, Jan, Grote, Ludger, Blomberg, Anders, Franklin, Karl, Sahlin, Carlin, Malinovschi, Andrei, Lindberg, Eva
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 17.11.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Allmänmedicin; Anthropometry; Body Mass Index; Cardiovascular disease; Chronic obstructive pulmonary disease; Cross-Sectional Studies; EPIDEMIOLOGY; Female; Forced Expiratory Volume; General Medicine; Humans; Hypoxemia; Hypoxia - physiopathology; Lung - physiopathology; Male; Middle Aged; Mortality; Obesity; Original Research; Oxygen saturation; Polysomnography; Pulmonary arteries; Pulse oximetry; Questionnaires; Registration; Respiration; Respiratory Function Test; Respiratory Function Tests; Risk factors; Sleep apnea; Sleep Apnea, Obstructive - physiopathology; SLEEP MEDICINE; Spirometry; Sweden - epidemiology; Vital Capacity; Womens health; Sweden; Germany; SLEEP MEDICINE; Respiratory Function Test; EPIDEMIOLOGY
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2024-086596

Obstructive sleep apnoea (OSA) and its associations with lung function.BackgroundOSA is highly prevalent and characterised by abnormal respiration during sleep. This large, population-based study aimed to investigate the associations between OSA and lung function in subjects aged 50–64 years.MethodThe population-based Swedish CArdioPulmonary bioimage Study includes information on anthropometry, comorbidities and spirometry. The current analysis included data from three centres (Gothenburg, Umeå and Uppsala) on whole-night respiratory polygraphy as a meta-analysis examining the overall effect size of lung function on sleep apnoea severity, expressed as ß-coefficient after stratifying for sex and adjusting for age, waist circumference and smoking status.Results Data from 9016 participants (54% women, age 58±4 years, body mass index 27±4 kg/m2 ) with sleep recordings of good quality were included in the final analysis. Forced expiratory volume during 1 s (FEV 1 ) (ß=−0.10 (95% CI −0.16 to −0.03)), forced vital capacity (FVC) (−0.15 (−0.21 to −0.10)) and diffusion capacity for carbon monoxide (DLCO ) (−0.08 (−0.10 to −0.05)) were all negatively associated with the oxygen desaturation index (ODI) and also with per cent of registration with nocturnal oxygen saturation <90% FVC (−0.44 (−0.87 to −0.01)), FEV 1 (−0.86 (−1.36 to −0.36)) and DL CO (−0.47 (−0.60 to −0.35)). Additionally, a positive association was observed between FEV 1 (0.13 (0.05 to 0.22)) and DL CO (0.07 (0.04 to 0.09)) with the mean nocturnal saturation. There was a negative association between DL CO and apnoea-hypopnoea index, AHI, (ß=−0.04 (95% CI−0.06 to −0.03)), while no associations were found between FEV 1 or FVC and AHI. ConclusionIn OSA, lower lung function is more distinctly associated with the nocturnal hypoxic burden than AHI. Potential lung function impairment should be investigated in OSA patients with a high ODI relative to AHI.