L'AUTO-ÉVALUATION NE PRÉDIT PAS LES MESURES OBJECTIVES DE LA VOIE RESPIRATOIRE CHEZ LES PATIENTS ATTEINTS D'AOS

Nascimento JA1, Nakagawa NK1
1Universidade de São Paulo (USP), São Paulo, Brazil

Contexte: Oronasal breathing may play an important role in the pathoghenesis of upper airway collapsibility and also impact on the choice of CPAP mask to treat OSA. Addictionaly, self-reported oronasal breathing route and nasal symptoms have been used for clinical decision of CPAP interface in OSA patients. However, the breathing route during sleep in patients with OSA is poorly understood and the association between self-reported and objectively measured breathing route is not known.

Objectif : We hypothesized that objectively measured oronasal breathing is more common in OSA patients than in controls but is not associated with self-reported breathing route.

Méthodologie: Seventeen patients with OSA and 9 healthy subjects underwent overnight polysomnography with an oronasal mask with 2-sealed compartments attached to independent pneumotacographs. Subjects answered questionnaires about nasal symptoms and perceived breathing route.

Résultats: Oronasal breathing was more common (p=0.010) among patients with OSA than controls while awake (65% vs 0%) and during sleep (71% vs 22%, respectively). Oronasal breathing was associated with OSA severity (p=0.038), age (p=0.001) and neck circumference (p=0.017). There was no agreement between objective measurement and self-reported breathing route among patients while awake (kappa=-0.12) and sleep (kappa=-0.02). No associations were found between nasal symptoms and oronasal breathing in patients with OSA (p=0.515).

Conclusion(s) : Oronasal breathing is more common among patients with OSA than controls both during wakefulness and sleep and is associated with OSA severity and anthropometric measures. Self-perception does not accurately predict objectively measured preferential breathing route.

Implications Oronasal breathing may play a pivotal role in the pathogenesis of OSA. Self-reported oronasal breathing route and nasal symptoms should be used with caution as evidence to support CPAP mask choice in OSA patients.

Mots clés: obstructive sleep apnea, nasal symptoms, oronasal breathing

Remerciements de financement : Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP 2013/13598-1 and 2017/10372-3).Brazilian National Council of Research (CNPq 470356/2013-8).

Topic: Cardiorespiratoire

Approbation éthique requise : Oui
Institution : Faculté de médecine de l'Université de São Paulo
Ethics committee: Ethical Committee of FMUSP
Numéro d'éthique : 102/13


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