Sleep disorders in obese patients and their association with small airway disease and lung ultrasound findings

Abstract

Introduction: Obesity is a complex and multifactorial disease, it has become a global challenge for public health in the last five decades, being driven by changes in eating patterns and an increase in sedentary lifestyle. In addition to negatively affecting several physiological functions, obesity is associated with metabolic syndrome, increasing the risk of non-communicable diseases, such as diabetes, cardiovascular diseases, cancer, obstructive sleep apnea (OSA) and others, as a tool for evaluating the effects of obesity in the lungs and airways, sensitive tools are increasingly used to identify lung abnormalities: the impulse oscillometry system (IOS) and lung ultrasound (USP). Objective: Our study aimed to correlate the risks of sleep disorders with abnormalities in lung mechanics, abnormal ultrasound signs and anthropometric parameters in adults with obesity. Methods: Fifty individuals with obesity were assessed for their risk of OSA using the Mallampati classification, Epworth sleepiness scale (ESS), STOP-Bang questionnaire and Sleep Apnea Clinical Score (SACS). They also submitted to IOS, spirometry and USP. Results: The following results were found: Abnormal spirometry, abnormal IOS and abnormal USP signals were observed in 24%, 84% and 72% of participants, respectively. None of the sleep scales showed significant differences between the subgroups with normal and abnormal spirometry. However, the frequency of ESS with high risk for OSA was higher in the subgroup with abnormal IOS (87.5%) than in the subgroup with normal IOS (42.9%) (P = 0.024). Regarding USP signs, the frequency of Mallampati classification with high risk for OSA was higher in the subgroup with B lines >2 (80%) than in the subgroup without B lines >2 (25.7%) (p=0.0003). The frequency of ESS with high risk for OSA was higher in the subgroup with the presence of subpleural consolidations (100%) than in the subgroup without the presence of subpleural consolidations (41.9%) (P = 0.004). Conclusion: With this, we conclude that in adults with obesity, the greater the risk for OSA, the worse the resistive and reactive parameters measured by IOS. Furthermore, abnormal IOS and abnormal USP signs are factors associated with a high risk for OSA.