Breathing frequency in sleep related respiratory disturbances

Pradella, Márcia

doi:10.1590/S0004-282X1993000200014

Abstracts

In normal adults, breathing frequency (f) is highly reproducible within an individual ranging from 8 to 25 min-1; during sleep, f is known to change only minimally. This variable is rarely reported in studies of adults with various sleep related respiratory disturbances (SRRD). We occasionally observed a spectacular increase of f during sleep in patients with SRRD associated with hypopnea and 02 desaturation. We undertook a retrospective study of 650 consecutive all-night polysomnographic recordings, in order to evaluate how often such an increase in breathing frequency occurs and with which factors it is associated. We excluded patients with major respiratory failure. We found 16 patients (11 males; mean ± SD, age: 45 ± 13 yrs; body mass index (BMI): 44±11 kg/m2) with f > 25 min-1 during sleep (tachypneic group, T). We performed a one-for-one matching for sex, age and BMI between the T and a control (C) group (age: 45±12 yrs; BMI 44±10 kg/m2), with similar sleep disturbances but normal f during sleep. We compared the f in each vigilance state by averaging five measurements of f, each of one minute duration in a stable period. We observed that: C patients showed no significant change in f in any vigilance state; T patients showed a higher f already during wakefulness (p<0.05) and f increased significantly in all sleep stages (<0.01). We compared the two groups for many clinical and polysomnographic variables. Significant statistical differences were observed for: f, arterial C02 tension (PaC02), vital capacity (VC), forced expiratory volume at one second (FBV1) and pulse frequency (PF).

breathing frequency; polysomnographic recording; sleep related respiratory disturbances

Em adultos normais, a frequência respiratória (f) varia de 8 a 25 min-1 com grande reprodutividade intraindividual: durante o sono, f é quase invariável. Esta variável tem sido raramente referida em estudos de pacientes com problemas respiratórios associados ao sono (SRRD). A observação ocasional de espetacular aumento da f durante o sono em pacientes com SRRD', principalmente apnéias/hipopnéias associadas à desaturação da oxi-he-moglobina, nos levou a proceder a estudo retrospectivo de 650 exames consecutivos de polisso-nografia (PSG), com a finalidade de avaliar a frequência da ocorrência desta aceleração da f e dos prováveis fatores a ela associados. Foram excluidos deste estudo pacientes com insuficiência respiratória grave. Observamos a ocorrência deste fenômeno em 16 pacientes (11 homens com média de idade 45±13 anos, índice de massa corporal (BMI) 44±11 kg/m2) para os quais a f foi maior que 25 min-1 durante o sono (grupo de taquipnéicos, T). Realizamos comparação da f entre T e grupo controle (C) de pacientes de mesmo sexo e semelhantes idades (45±12 anos) e, BMI (44±10 kg/ni2) e SRKD, em cada estado de vigilância, fazendo média de 5 contagens da f, cada uma feita durante 1 minuto e durante um período estável do determinado estado de vigilância, Observamos que: os pacientes do grupo C não apresentaram alteração significativa da f em qualquer estado de vigilância; os pacientes do grupo T já tinham f maior que os pacientes do grupo C (p < 0.05) quando acordados e esta aumentou significativamente em todos os estados do sono (p< 0.01 f quando acordados vs f durante o sono, p < 0.001 T vs C durante o sono). Comparamos os dois grupos para vários parâmetros clínicos e polissonográficos. Diferença estatisticamente significante foi observada para os dados de: PaCO-2 (pressão arterial do C02), capacidade vital (VC), volume expiratório em 1 segundo (FEV1) e da frequência do pulso (PF) durante repouso (acordados) e durante o sono.

frequência respiratória; registro polissonográfico; problemas respiratórios relacionados ao sono

Márcia Pradella

Sleep Laboratory, St. Luc Training Hospital Université Catholique de Louvain, Brussels

SUMMARY

In normal adults, breathing frequency (f) is highly reproducible within an individual ranging from 8 to 25 min-1; during sleep, f is known to change only minimally. This variable is rarely reported in studies of adults with various sleep related respiratory disturbances (SRRD). We occasionally observed a spectacular increase of f during sleep in patients with SRRD associated with hypopnea and 02 desaturation. We undertook a retrospective study of 650 consecutive all-night polysomnographic recordings, in order to evaluate how often such an increase in breathing frequency occurs and with which factors it is associated. We excluded patients with major respiratory failure. We found 16 patients (11 males; mean ± SD, age: 45 ± 13 yrs; body mass index (BMI): 44±11 kg/m2) with f > 25 min-1 during sleep (tachypneic group, T). We performed a one-for-one matching for sex, age and BMI between the T and a control (C) group (age: 45±12 yrs; BMI 44±10 kg/m2), with similar sleep disturbances but normal f during sleep. We compared the f in each vigilance state by averaging five measurements of f, each of one minute duration in a stable period. We observed that: C patients showed no significant change in f in any vigilance state; T patients showed a higher f already during wakefulness (p<0.05) and f increased significantly in all sleep stages (<0.01). We compared the two groups for many clinical and polysomnographic variables. Significant statistical differences were observed for: f, arterial C02 tension (PaC02), vital capacity (VC), forced expiratory volume at one second (FBV1) and pulse frequency (PF).

Key words: breathing frequency, polysomnographic recording, sleep related respiratory disturbances.

RESUMO

Em adultos normais, a frequência respiratória (f) varia de 8 a 25 min-1 com grande reprodutividade intraindividual: durante o sono, f é quase invariável. Esta variável tem sido raramente referida em estudos de pacientes com problemas respiratórios associados ao sono (SRRD). A observação ocasional de espetacular aumento da f durante o sono em pacientes com SRRD', principalmente apnéias/hipopnéias associadas à desaturação da oxi-he-moglobina, nos levou a proceder a estudo retrospectivo de 650 exames consecutivos de polisso-nografia (PSG), com a finalidade de avaliar a frequência da ocorrência desta aceleração da f e dos prováveis fatores a ela associados. Foram excluidos deste estudo pacientes com insuficiência respiratória grave. Observamos a ocorrência deste fenômeno em 16 pacientes (11 homens com média de idade 45±13 anos, índice de massa corporal (BMI) 44±11 kg/m2) para os quais a f foi maior que 25 min-1 durante o sono (grupo de taquipnéicos, T). Realizamos comparação da f entre T e grupo controle (C) de pacientes de mesmo sexo e semelhantes idades (45±12 anos) e, BMI (44±10 kg/ni2) e SRKD, em cada estado de vigilância, fazendo média de 5 contagens da f, cada uma feita durante 1 minuto e durante um período estável do determinado estado de vigilância, Observamos que: os pacientes do grupo C não apresentaram alteração significativa da f em qualquer estado de vigilância; os pacientes do grupo T já tinham f maior que os pacientes do grupo C (p < 0.05) quando acordados e esta aumentou significativamente em todos os estados do sono (p< 0.01 f quando acordados vs f durante o sono, p < 0.001 T vs C durante o sono). Comparamos os dois grupos para vários parâmetros clínicos e polissonográficos. Diferença estatisticamente significante foi observada para os dados de: PaCO-2 (pressão arterial do C02), capacidade vital (VC), volume expiratório em 1 segundo (FEV1) e da frequência do pulso (PF) durante repouso (acordados) e durante o sono.

Palavras-chave: frequência respiratória, registro polissonográfico, problemas respiratórios relacionados ao sono.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

Acknowledgements The author would like to thank director of the Sleep Laboratory at St. Luc training Hospital Prof. G Aubert and the Consultant Pneumologist of the same laboratory Prof. D. Rodenstein for their helpful remarks in the writing up of this study.

Aceite: 11-setembro-1992.

Dra. Márcia Pradella Laboratoire de Sommeil, Hopital St. Luc Avenue Hippocrate 10 1200 Brussels Belgium.

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