Fev1/Fvc Is Linked to the Severity of Osa in a Multivariate Regression Analysis Publisher Pubmed



Erfanian R ; Zare M ; Heidari R ; Khamushian P ; Heidari F ; Keyfari Alamdari M
Source: Sleep and Breathing Published:2025

Abstract

Purpose: Obstructive sleep apnea (OSA) results from interactions between upper airway anatomy, neuromuscular control, and lung function. While much attention has focused on upper airway collapse during sleep, the impact of intrathoracic airways and lung volume is also important. This study seeks to understand the role of impaired lung function in the severity of OSA, while also taking other factors into account. Understanding this relationship may help predict improvements in OSA severity from interventions that enhance lung function. Method: Patients with suspected OSA were enrolled in the study. We recorded their age, gender, BMI, Friedman Tongue Position, and Friedman Tonsil Grade. Every participant underwent polysomnography. Spirometry measurements included FEV1/FVC ratios and predicted percentages for FVC, FEV1, and FEV1/FVC. A backward entry multivariate regression model was employed to predict AHI, identifying significant predictors among the variables. In addition, comparative analysis of spirometric parameters was conducted among mild (AHI < 15), moderate (15 < = AHI < 30), and severe (AHI > 30) groups. Result: This study enrolled 112 participants, with an average age of 36.9 years (SD = 8.0); 71.0% were male, and 34.5% were smokers. The final predictive AHI model revealed a significant negative association between FEV1/FVC and AHI (standardized beta = -0.291, p < 0.001). Additionally, positive associations were observed with BMI (standardized beta = 0.362, p < 0.001) and male gender (standardized beta = 0.237, p = 0.009). After adjusting for BMI, age, and gender, the mild OSA group demonstrated significantly higher FEV1/FVC (p = 0.008), predicted percentage FEV1/FVC (p = 0.009), and predicted percentage of FEV1 (p = 0.02) compared to the severe OSA group. Conclusion: The FEV1/FVC ratio is a crucial predictor of OSA severity. A lower FEV1/FVC ratio significantly impacts AHI, indicating increased airway obstruction that could exacerbate OSA. It is also plausible that a shared underlying issue contributes to both lower and upper airway obstructions. Further research is necessary to validate these findings and investigate the relationship between lower airway obstruction and OSA. © 2025 Elsevier B.V., All rights reserved.