Relationship between parenchymal involvement and obstructive sleep apnea in subjects with sarcoidosis

Clin Respir J. 2015 Jan;9(1):14-21. doi: 10.1111/crj.12098. Epub 2014 Feb 17.

Abstract

Introduction: Increased obstructive sleep apnea (OSA) incidence has been reported in sarcoidosis. However, no research has been conducted to determine the relation between OSA and pulmonary parenchymal involvement in sarcoidosis.

Objectives: We investigated OSA frequency and association between pulmonary parenchymal involvement and OSA in sarcoidosis. Additionally, relationship between lung functions and polysomnography data was assessed.

Methods: The study enrolled sarcoidosis subjects with or without pulmonary parenchymal involvement. Spirometry, diffusion capacity, 6-min walking test, arterial blood gases, chest X-ray, Epworth sleepiness scale (ESS) and polysomnography were performed. Subjects with body mass index (BMI) ≥30 or significant upper airway pathologies that might cause OSA were excluded.

Results: A total of 29 sarcoidosis subjects (15 with, 14 without parenchymal involvement) with mean age 43.8 ± 9.4 years were analyzed. Twenty-seven of them were female. BMI was 26.8 ± 4.2 kg/m(2) . Mean forced expiratory volume 1 s (FEV1 ) was 97.89% ± 20.21%, and forced vital capacity (FVC) was 102.86 ± 18.14%. ESS score was 4 ± 1.6. OSA was identified in 51.7% (n = 15) of subjects. Apnea-hypopnea index (AHI) was 16.16 ± 19/h and oxygen desaturation index (ODI) was 22.3 ± 25.99 among subjects with OSA. Sleep apnea related with rapid eye movement was present in 40% of OSA subjects. AHI and ODI were higher among sarcoidosis subjects with parenchymal involvement (P = 0.019, P = 0.026). OSA frequency was higher in the group with parenchymal involvement, but the difference was not statistically significant (n = 10/15, %66 vs n = 5/14, %35). FEV1 and FVC were not related with AHI and ODI.

Conclusion: We found a high rate of OSA in sarcoidosis. There was a trend of high OSA frequency in sarcoidosis subjects with parenchymal involvement.

Keywords: Apnea-hypopnea index; obstructive sleep apnea; sarcoidosis; stage II sarcoidosis.

MeSH terms

  • Adult
  • Blood Gas Analysis
  • Body Mass Index
  • Cross-Sectional Studies
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Polysomnography
  • Risk Factors
  • Sarcoidosis, Pulmonary / complications*
  • Sarcoidosis, Pulmonary / pathology*
  • Sarcoidosis, Pulmonary / physiopathology
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / epidemiology*
  • Sleep Apnea, Obstructive / physiopathology
  • Vital Capacity