Obstructive Sleep Apnea Effects on Pulmonary and Respiratory Muscle Function of Obese Children and Adolescents: A Preliminary Study

Pratanaphon, Sainatee; Sonsuwan, Nuntigar; Chaimano, Siwahdol; Chandee, Sirinad; Autkhruea, Kewalin; Sa‐nguanmoo, Piangkwan; Wonglangka, Khanittha

doi:10.5152/turkthoracj.2022.21115

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…7 A recent preliminary study found that respiratory muscle strength and endurance of children and adolescents with OSA and obesity were likely to be lower than the controls, but this is not statistically different (all, p>0.05). 8 The maximal inspiratory pressure (MIP) of this group, which refers to respiratory muscle strength are comparable to those of children with severe obesity, were inferior to normal weight individuals and thus may be considered abnormal. 9,10 These results suggested a potential risk of pulmonary and/or respiratory muscle dysfunction in children with OSA and/or obesity.…”

Section: Case Descriptionmentioning

confidence: 90%

Feasibility of inspiratory muscle training to improve pulmonary and respiratory muscle function, and for attenuating sleep apnea symptoms in children and adolescent with obstructive sleep apnea and obesity: Case report

Sornkla¹,

Sonsuwan²,

Pratanaphon³

2022

JAMS

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Background: Studies have demonstrated a potential risk of pulmonary and respiratory muscle dysfunction in individuals with obstructive sleep apnea (OSA) and/or obesity. Inspiratory muscle training (IMT) is an adjunct intervention designed to improve respiratory muscle strength, decrease severity of OSA, and to enhance sleep quality in adults with OSA. However, its effects on children with OSA and obesity are still largely unknown. Objectives: This case report aims to show the feasibility and the effects of IMT on pulmonary and respiratory muscle function and sleep apnea symptoms of children and adolescents with OSA and obesity. Case description: Four children and one adolescent who were diagnosed with OSA and classified as obesity underwent IMT with training load at 60% of the individual’s maximal inspiratory pressure (MIP) for 12 weeks. Results: No adverse effects occurred during evaluation and IMT. The participants’ compliance with IMT varied from 77.4% to 100%. After 12-week of IMT, MIP and maximal voluntary ventilation (MVV) increased from baseline, varying from 8.0% to 83.5% and 0.1% to 36.1%, respectively. Scores in the Sleep Related Breathing Disorder-Pediatric Sleep Questionnaire (SRBD-PSQ) tended to decrease rapidly at week 3. Thereafter, participants responded differently toward the end of IMT. Changes in pulmonary function variables were not observed. Conclusion: Improvements in respiratory muscle strength, endurance, and SRBD-PSQ scores occurred after IMT, suggesting the feasibility of IMT for increasing inspiratory muscle performance and for ameliorating sleep apnea symptoms in children and adolescents with OSA and obesity. However, pulmonary function was unaffected by IMT

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Section: Case Descriptionmentioning

confidence: 90%

Feasibility of inspiratory muscle training to improve pulmonary and respiratory muscle function, and for attenuating sleep apnea symptoms in children and adolescent with obstructive sleep apnea and obesity: Case report

Sornkla¹,

Sonsuwan²,

Pratanaphon³

2022

JAMS

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“…The main finding of this study was that an inverse and significant correlation between FEV 1 and OAHI was documented. In children, a study conducted by Dr. Pratanaphon et al reported that children with obesity and OSA had a significant reduction in maximal mid-expiratory flow, forced expiratory flow at 75%, and forced expiratory flow at 50% with no differences in FEV 1 , FEV 1 /CVF and peak expiratory flow (PEF) variables (15). Similar findings were found in the study of Dr. Eyck et al where in obese children with OSA a significant decrease in FVC and FEV 1 was documented in those with moderate and severe OSA.…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Pulmonary Function Tests and the Apnea-Hypopnea Index in Asthmatic Children

Severiche-Bueno,

Escamilla,

Benavides

et al. 2023

Preprint

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Introduction: OSA in children is an under-recognized and under-diagnosed disease and is an independent risk factor for poor asthma control and an increased number of exacerbations. The association of asthma and OSA is well documented in adults and to a lesser extent in the pediatric population. The association of AHI and lung function in children in a high-altitude city is not described in the literature. Methods: This cross-sectional observational study involved children with asthma (n=64) between 3 and 12 years of age referred to our center in Bogotá (2640m) for polysomnogram between 2012 and 2017. Clinical history, spirometry, oscillometry, and polysomnogram were carried out. OSA was defined from the polysomnographic point of view, as the presence of an obstructive Apnea hypopnea index ≥ 1/hour Results: A total of 64 children with asthma were included. 59.34% were boys and the median age was 7 years. 59.4% of the participants had moderate or severe asthma and 59.4% had uncontrolled asthma. A significant correlation was found between BMI and OAHI. Concerning pulmonary function, a significant negative correlation was found between pre-bronchodilator FEV1 and OAHI as well as a significant correlation between FEV1/FVC and CAHI. For oscillometry, R5 showed a significant negative correlation with AHI. Conclusions: We found in children with asthma living in a high-altitude city a significant and negative correlation between FEV and R5 with AHI as well as a significant and negative correlation between FEV /FVC ratio and CAHI. These findings suggest a correlation between distal airway diameter and sleep apnea severity.

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“…Patients with OSA may present excessive daytime sleepiness, fatigue and reduced attention, which result in poor quality of life (Liu et al, 2021) and increased risk for deterioration in cognitive function (Bubu et al, 2020), traffic accidents (Gottlieb et al, 2018), metabolic diseases (Patinkin et al, 2016), cardiovascular diseases (Hou et al, 2018) and mortality (Butler et al, 2019). Studies have also shown that airway obstruction and hypoxia resulting from OSA can, over time, overwhelm respiratory muscle function and ventilatory work, and may lead to a decline in lung volumes (Kim et al, 2023; Pratanaphon et al, 2022). Of note, previous evidence has been found that respiratory muscle training (RMT) may improve pulmonary function in patients with OSA (Lin, Chiang, et al, 2020), but no previous systematic review has pooled results of these studies.…”

Section: Introductionmentioning

confidence: 99%

“…This decline in pulmonary function may even be intensified when associated with obesity (Pratanaphon et al, 2022). Obesity is probably the most important risk factor for OSA (Carneiro & Zanella, 2018), affecting over 70% of people with OSA.…”

Section: Introductionmentioning

confidence: 99%

Respiratory muscle training for obstructive sleep apnea: Systematic review and meta‐analysis

Sousa

Rocha

Tavares

et al. 2023

Journal of Sleep Research

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SummaryObstructive sleep apnea is the most common sleep disorder. This review aims to evaluate the effectiveness and safety of respiratory muscle training in the treatment of patients with obstructive sleep apnea. The study protocol was registered in Prospero Platform (CRD42018096980). We performed searches in the main databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) via Pubmed; Excerpta Medica dataBASE (Embase) via Elsevier; Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library; Latin American and Caribbean Literature on Health Sciences (LILACS) through the Portal of the Virtual Health Library and Physiotherapy Evidence Database (PEDro) for all randomised–controlled trials published before July 2022. The randomised–controlled trials were assessed for risk of bias and certainty of evidence. Thirteen randomised–controlled trials were included. All studies had an overall high risk of bias. Inspiratory muscle training probably improves systolic blood pressure and sleepiness when compared with sham. However, inspiratory muscle training probably does not improve diastolic blood pressure and maximum expiratory pressure, and may not be superior to sham for apnea–hypopnea index, forced expiratory volume in 1 s, forced vital capacity, sleep quality and quality of life. In addition, it is uncertain whether there is any effect of inspiratory muscle training on maximum inspiratory pressure and physical capacity. Inspiratory muscle training may also improve maximum inspiratory pressure and maximum expiratory pressure compared with oropharyngeal exercises. However, it may not be superior for apnea–hypopnea index, sleep quality, sleepiness, quality of life and functional capacity. When associated with physical exercise, inspiratory muscle training may not be superior to physical exercise alone for maximum inspiratory pressure, maximum expiratory pressure, systolic and diastolic blood pressure, and functional capacity. At the same time, when associated with cardiac rehabilitation exercises, inspiratory muscle training may reduce apnea–hypopnea index, improve inspiratory muscle strength, sleepiness and sleep quality compared with cardiac rehabilitation alone. However, it may not be superior for improving quality of life. Regarding expiratory muscle training, it may improve expiratory muscle strength and sleep quality, but not sleepiness when compared with sham. The evidence on the effects of expiratory muscle training in apnea–hypopnea index is very uncertain.

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Obstructive Sleep Apnea Effects on Pulmonary and Respiratory Muscle Function of Obese Children and Adolescents: A Preliminary Study

Cited by 3 publications

References 27 publications

Feasibility of inspiratory muscle training to improve pulmonary and respiratory muscle function, and for attenuating sleep apnea symptoms in children and adolescent with obstructive sleep apnea and obesity: Case report

Feasibility of inspiratory muscle training to improve pulmonary and respiratory muscle function, and for attenuating sleep apnea symptoms in children and adolescent with obstructive sleep apnea and obesity: Case report

Correlation Between Pulmonary Function Tests and the Apnea-Hypopnea Index in Asthmatic Children

Respiratory muscle training for obstructive sleep apnea: Systematic review and meta‐analysis

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