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Background and objective  The aim of this study was to investigate whether the maximum inspiratory and expiratory pressure are correlated with the apnea-hypopnea index (AHI) in patients with obstructive sleep apnea syndrome (OSAS).  Methods  Fifty-two patients with OSAS were divided into two groups (AHI, events/hours: <30, n=28, versus ≥30, n=24). For each patient, anthropometric characteristics, spirometry parameters, maximum inspiratory (MIP) and expiratory pressure (MEP), and cardiopulmonary function (CPF) parameters (oxygen uptake at rest (VO 2 ), carbon dioxide output (VCO 2 ), heart rate (HR), minute ventilation (V E ), tidal volume at inspiratory (TVin) and expiratory (TVex), breath frequency ( f  β ), end-tidal carbon dioxide pressure (P ET CO 2 ), end-tidal oxygen pressure (P ET O 2 ), and mean arterial pressure (MAP)) in sitting position for three minutes were recorded. The independent t-test was used to measure the differences between groups (events/hours <30 versus ≥30) and Pearson correlation analysis was used for statistical comparison between parameters.  Results  Results showed differences between groups (AHI, events/h ≥30 versus <30) in MIP (102.0±18.3 versus 91.1±12.1 % of predicted, p=0.013) and CPF parameters TVin (0.8±0.2 versus 0.7±0.1, L, p=0.047), P ET CO 2  (34.6±4.2 versus 31.4±3.7, mmHg, p=0.007), and MAP (88.4±6.5 versus 82.9±6.2, mmHg, p=0.003). Pearson correlation analysis between respiratory muscle strength (MIP and MEP) and polysomnography (PSG) parameters, MIP is related to AHI (r=.332, p=0.016) and desaturation index (r=.439, p=0.001), as well as MEP to percent of REM sleep stage (r=-.564, p<0.001).  Conclusion  The data from the present study support that maximal inspiratory pressure relates to the severity of AHI and intermittent breath-holding during sleep increases the inspiratory muscle strength.

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Respiratory Muscle Strength as an Indicator of the Severity of the Apnea-Hypopnea Index: Stepping Towards the Distinction Between Sleep Apnea and Breath Holding