Examination of the diaphragm in obstructive sleep apnea using ultrasound imaging

Abstract

Purpose The aim of this study was to analyze the effect of obstructive sleep apnea (OSA) on the ultrasound (US) features of the diaphragm and to determine if diaphragmatic US may be a useful screening tool for patients with possible OSA. Methods Patients complaining of snoring were prospectively enrolled for overnight polygraphy using the ApneaLink Air device. Thickness and motion of the diaphragm during tidal and deep inspiration were measured. Logistic regression was used to assess parameters of the diaphragm associated with OSA. Results Of 100 patients, 64 were defined as having OSA. Thicknesses of the left and right hemidiaphragms were significantly different between OSA and control groups. Using a combination of diaphragmatic dimensions, diaphragm dilation, age, sex, and BMI, we developed an algorithm that predicted the presence of OSA with 91% sensitivity and 81% specificity. Conclusion A combination of anthropometric measurements, demographic factors, and US imaging may be useful for screening patients for possible OSA. These findings need to be confirmed in larger sample sizes in different clinical settings.

Insights into the Use of Point-of-Care Ultrasound for Diagnosing Obstructive Sleep Apnea

“…Moreover, diaphragm thickness also correlated (r = 0.4) with the severity of the disease. Recently, Molnár et al developed an algorithm based on diaphragm parameters [ 75 ]. The authors also studied movement and further developed a statistical tool to predict OSA.…”

Obstructive Sleep Apnea and Role of the Diaphragm

“…What do know about the adaptation of the DM with OSA? DM appears to have a greater thickness in patients, through ultrasound measurements, but we do not know if this increase in size is related to hypertrophy (overcoming constant air resistance) or fibrosis (constant inflammation) [115,116]. An increase in thickness could be the result of greater constant contraction of the muscle due to constant obstructions of the upper airways.…”

Investigation of respiratory muscle function, pulmonary function, and exercise capacity in women and men with obstructive sleep apnea syndrome

“…34 Kadın ve erkek OUAS'ta 6DYT ile egzersiz kapasitesinin değerlendirildiği az sayıda çalışma vardır. 38 Pływaczewski vd., 35 kadın OUAS olgularının 6DYT mesafesinin erkeklerden daha düşük olduğunu göstermiştir. Çalışmada kadın ve erkek olgular arasındaki 6DYT mesafesi farkı ortalama 50 m'dir.…”

“…OUAS'ta ultrasonla değerlendirilen diyafragma kalınlığının arttığı gösterilmiştir. 38 OUAS'ta üst havayolu obstrüksiyonu solunum aktivitesini artırarak solunum kaslarında hipertrofiye neden oluyor olabilir. 34…”