Obstructive sleep apnoea and lung function, and their association with nocturnal hypoxemia: results from the Swedish CArdioPulmonary bioimage Study (SCAPIS) – a cross-sectional study

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Abstract
Obstructive sleep apnoea (OSA) and its associations with lung function. Background: OSA is highly prevalent and characterised by abnormal respiration during sleep. This large, population-based study aimed to investigate the associations between OSA and lung function in subjects aged 50–64 years. Method: The population-based Swedish CArdioPulmonary bioimage Study includes information on anthropometry, comorbidities and spirometry. The current analysis included data from three centres (Gothenburg, Umeå and Uppsala) on whole-night respiratory polygraphy as a meta-analysis examining the overall effect size of lung function on sleep apnoea severity, expressed as ß-coefficient after stratifying for sex and adjusting for age, waist circumference and smoking status. Results: Data from 9016 participants ( 54% women, age 58±4 years , body mass index 27±4 kg/m 2 ) with sleep recordings of good quality were included in the final analysis. Forced expiratory volume during 1 s (FEV 1 ) ( ß=−0.10 (95% CI −0.16 to −0.03) ), forced vital capacity ( FVC ) ( −0.15 (−0.21 to −0.10) ) and diffusion capacity for carbon monoxide ( DL CO ) ( −0.08 (−0.10 to −0.05) ) were all negatively associated with the oxygen desaturation index (ODI) and also with per cent of registration with nocturnal oxygen saturation 1 ( −0.86 (−1.36 to −0.36 )) and DL CO ( −0.47 (−0.60 to −0.35) ). Additionally, a positive association was observed between FEV 1 ( 0.13 (0.05 to 0.22) ) and DL CO ( 0.07 (0.04 to 0.09) ) with the mean nocturnal saturation. There was a negative association between DL CO and apnoea-hypopnoea index , AHI, ( ß=−0.04 (95% CI−0.06 to −0.03) ), while no associations were found between FEV 1 or FVC and AHI. Conclusion: In OSA, lower lung function is more distinctly associated with the nocturnal hypoxic burden than AHI. Potential lung function impairment should be investigated in OSA patients with a high ODI relative to AHI.
Funding Information
  • Umeå University and University Hospital
  • the Swedish Research Council
  • The Swedish Heart Lung Foundation (20200485)
  • Lund and Skåne University Hospital
  • Sahlgrenska University Hospitals Research Foundations
  • Karolinska Institutet
  • VINNOVA
  • Linköping University
  • Stockholm County Council
  • The University of Gothenburg
  • Linköping University Hospital
  • the Knut and Alice Wallenberg Foundation
  • Uppsala University and University Hospital
  • Lund University Medical Faculty Foundation

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