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Relationship between the Upper Airway and Obstructive Sleep Apnea-Hypopnea Syndrome in Morbidly Obese Women

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Background

The authors studied changes in the upper airway in morbidly obese women and the relationship to sleep apnea-hypopnea syndrome (OSAS).

Methods

Patients underwent a cardiorespiratory polygraphic study, respiratory function test (spirometry, plethysmography, maximum inspiratory pressures and arterial blood gas analysis), and computed tomographic studies of the upper airway.

Results

40 morbidly obese women being evaluated for bariatric surgery (mean age 39.6 ±–.6 years old, BMI 48.7 ±–.6 kg/m2) were studied. 37 women had OSAS, and 14 had severe OSAS. Results on respiratory function tests were normal. BMI and weight had a positive correlation with apnea-hypopnea index (AHI), apnea index (AI), desaturation index (DI), lowest oxygen saturation and CT90. Uvula diameter had a negative correlation with FEV1, FVC, VC IN and a positive correlation with TLC. Retropharynx soft tissue at the retropalatal level had a negative correlation with FEV1, FVC and VC IN. The oropharynx area at maximal inspiration (total lung capacity) obtained a negative correlation with the AHI (r– −0.423, P––.044), AI (r– −0.484, P––.042) and DI (r– −0.484, P––.019).

Conclusions

Prevalence of OSAS in morbidly obese women is very high. Our results show the significant correlation between BMI and AHI in morbidly obese women. Uvula diameter and retropharynx soft tissue are the upper airway parameters with higher relationship with pulmonary function. A reduction in the cross-sectional area of the airway at the level of the oropharynx could be related to the severity of OSAS in morbidly obese women.

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Abbreviations

FRC:

functional residual capacity

ERV:

expiratory reserve volume

FEV1:

forced expiratory volume in 1 second

FVC:

forced vital capacity

VC IN:

vital capacity on inspiration

TLC:

total lung capacity

RT:

retropharyngeal tissue

CT90:

% of time with O

DI:

desaturation index

PO.1:

mouth occlusion pressure at 100 ms beginning inspiratioin

TTmu :

tension-time index of inspiratory muscles

Rtot :

total airway resistance

PImax :

maximal static inspiratory pressure

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Authors and Affiliations

  1. Dept. of Pneumology, La Paz Hospital, Madrid, Spain

    A. Santiago-Recuerda, J. Villamor & R. Álvarez-Sala

  2. Dept. of Pneumology, Príncipe de Asturias Hospital, Alcalá de Henares, Madrid, Spain

    F. J. Gómez-Terreros

  3. Dept. of Radiology, La Princesa Hospital, Madrid, Spain

    P. Caballero & M. J. Soleto

  4. Dept. of Surgery, Alcalá de Henares University, Madrid, Spain

    A. Martín-Duce

  5. General Surgery, La Paz Hospital, Madrid, Spain

    G. Vesperinas

  6. Dept. of Statistics, La Paz Hospital, Madrid, Spain

    E. Pérez-Fernández

  7. C/Isla de Arosa 8, 14 B., 28035, Madrid, Spain

    A. Santiago-Recuerda

Authors
  1. A. Santiago-Recuerda
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  2. F. J. Gómez-Terreros
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  3. P. Caballero
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  4. A. Martín-Duce
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  6. G. Vesperinas
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  8. J. Villamor
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  9. R. Álvarez-Sala
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Correspondence to A. Santiago-Recuerda.

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Santiago-Recuerda, A., Gómez-Terreros, F.J., Caballero, P. et al. Relationship between the Upper Airway and Obstructive Sleep Apnea-Hypopnea Syndrome in Morbidly Obese Women. OBES SURG 17, 689–697 (2007). https://doi.org/10.1007/s11695-007-9120-4

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  • DOI: https://doi.org/10.1007/s11695-007-9120-4

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