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Ultrasonographic changes and impact factors of diaphragmatic function in patients with obstructive sleep apnea–hypopnea syndrome

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Diaphragmatic impairment has been reported in obstructive sleep apnea–hypopnea syndrome (OSAHS) patients. However, the risk factors of diaphragmatic dysfunction are unclear. This study was conducted to evaluate the diaphragmatic function and to investigate impact factors of ultrasonographic changes of the diaphragm in OSAHS patients.

Methods

This cross-sectional study recruited 150 snoring patients. All patients were divided into the control group (AHI < 5/h, n = 20), the mild-to-moderate OSAHS group (5/h ≤ AHI ≤ 30/h, n = 61), and the severe OSAHS group (AHI > 30/h, n = 69). Diaphragmatic thickness at function residual capacity (TFRC) and total lung capacity (TTLC) were measured by two-dimensional ultrasound, and the diaphragmatic excursion during tidal and deep breath was measured by M-mode ultrasound. The diaphragmatic thickening fraction (TF) was calculated. Spearman analysis and multiple linear stepwise regression analysis were conducted to analyze the impact factors of diaphragmatic function.

Results

TFRC in the control group, mild-to-moderate OSAHS group, and severe OSAHS group was 1.23 (1.10, 1.39) mm, 1.60 (1.43, 1.85) mm, and 1.90 (1.70, 2.25) mm; TTLC was 2.75 (2.53, 2.93) mm, 3.25 (2.90, 3.55) mm, and 3.60 (3.33, 3.90) mm, and TF was 119.23% (102.94, 155.97), 96.55% (74.34, 119.11), and 85.29% (60.68,101.22). There were across-group significant differences in TFRC, TTLC, and TF (P < 0.05). The oxygen desaturation index was the influencing factor of TFRC, TTLC, and TF (P < 0.05).

Conclusion

The diaphragm is thickened and diaphragmatic contractility is decreased in OSAHS patients. Nocturnal intermittent hypoxia is a risk factor for diaphragmatic hypertrophy and impaired diaphragmatic contractility.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank the technicians in the Department of Sleeping Center at the Second Affiliated Hospital of Soochow University for their technical assistance throughout the study.

Funding

This work was supported by the National Natural Science Foundation of China (grant/award number: 82070095).

Author information

Author notes

  1. Zhijun Wang and Jing Li contributed equally to this work.

Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, China

    Zhijun Wang & Rui Chen

  2. Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, China

    Jing Li & Yingchun Zhang

  3. Department of Sleeping Center, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, Jiangsu, China

    Rui Chen

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  1. Zhijun Wang
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  2. Jing Li
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Contributions

Conceptualization: Zhijun Wang, Jing Li, and Yingchun Zhang; Methodology: Zhijun Wang, Jing Li, and Yingchun Zhang; Formal analysis and investigation: Zhijun Wang, and Jing Li; Writing–original draft preparation: Zhijun Wang; Writing–review and editing: Jing Li, Yingchun Zhang, and Rui Chen; Funding acquisition: Rui Chen; Supervision: Rui Chen. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Rui Chen.

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Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Research Ethics Committee of the Second Affiliated Hospital of Soochow University, Suzhou, China (JD-LK-2018–004-02) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Wang, Z., Li, J., Zhang, Y. et al. Ultrasonographic changes and impact factors of diaphragmatic function in patients with obstructive sleep apnea–hypopnea syndrome. Sleep Breath (2024). https://doi.org/10.1007/s11325-024-03010-7

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  • DOI: https://doi.org/10.1007/s11325-024-03010-7

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