The relationship between sleep disorders and bronchiectasis has not been well described. We hypothesize that, due to the irreversible dilatation of the bronchi, the presence of secretions, and airflow obstruction, patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousal. A cross-sectional observational study was performed involving 49 patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis (NCFB). All patients underwent clinical evaluation, spirometry, and polysomnography, and were evaluated for the presence of excessive daytime sleepiness (EDS) and risk of obstructive sleep apnea (OSA). The mean age of the participants was 50.3 ± 13.6 years; 51.1% of patients were male and had a mean body mass index of 23.8 ± 3.4 kg/m2. The mean total sleep time (TST) was 325.15 ± 64.22 min with a slight reduction in sleep efficiency (84.01 ± 29.2%). Regarding sleep stages, stage 1 sleep and REM sleep were abnormal. OSA was present in 40.82% of the patients. The mean arousal index was 5.6 ± 2.9/h and snoring was observed in 71.43% of the patients. The oxygen desaturation index (ODI) was 14.35 ± 15.36/h, mean minimum oxygen saturation (SpO2 nadir) was 83.29 ± 7.99%, and mean TST with an SpO2 less than 90% was 30.21 ± 60.48 min. EDS was exhibited by 53.06% of the patients and 55.1% were at high risk of developing OSA. The patients infected by Pseudomonas aeruginosa had higher apnea-hypopnea indices, ODI, and TST with SpO2 < 90%, and lower values of SpO2 nadir. Adult patients with clinically stable NCFB, especially those infected by Pseudomonas aeruginosa, display EDS and a high prevalence of OSA, associated with considerable oxygen desaturation during sleep.
IntroductionBronchiectasis is a chronic disorder characterised by permanent and irreversible abnormal dilation of the bronchi and bronchioles, primarily caused by repeated cycles of pulmonary infections and inflammation, which lead to reduced mucociliary clearance and to the excessive production of sputum. Patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousals and thereby reduce the quality of life, because of the irreversible dilation of the bronchi and the presence of secretions and airflow obstruction.Methods and analysisFor this cross-sectional observational study, patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis will be recruited from the Bronchiectasis Clinic of the Pneumology Department of the Santa Casa de Misericordia Hospital and the Federal University of São Paulo (São Paulo, Brazil). Patients of either sex will be included if high-resolution CT of the thorax and classic sweat test confirms they have non-cystic fibrosis bronchiectasis, are between 18 and 80 years old, use long-acting bronchodilators, are clinically stable for a least 1 month, agree to participate in the study and they sign a statement of informed consent. The first part of the study will involve a clinical evaluation, maximal respiratory pressures, spirometry and the Saint George's Respiratory Questionnaire. The Sleep Laboratory of the Master's and Doctoral Postgraduate Program in Rehabilitation Sciences of the Nove de Julho University (São Paulo, Brazil) will perform the polysomnographic studies, Berlin Questionnaire, Epworth Sleepiness Scale, waist and neck circumferences, modified Mallampati classification and tonsil index.Ethics and disseminationThis protocol has been approved by the Human Research Ethics Committees of Santa Casa de Misericordia Hospital (process number 178/2012) and Human Research Ethics Committee of Nove de Julho University (process number 370474/2010). All participants will sign a statement of informed consent. The study findings will be published in peer-reviewed journals and presented at conferences.
O exercício físico é considerado atualmente como alternativa não farmacológica para melhora da qualidadedo sono, porém pela falta de conhecimento de alguns profissionais o mesmo não é muito utilizado para essa finalidade. Dessa forma, o objetivo deste estudo foi comparar a qualidade do sono, a presença de distúrbios do sono e insônia, e a qualidade de vida em pacientes praticantes de exercício físico regular (PEFR) e não praticantes de exercício físico regular (NPEFR), assistidos em UBS´s do município de Divinópolis, Minas Gerais. O estudo foi do tipo observacional transversal, realizado com 49 pacientes recrutados a partir de Unidades Básicas de Saúde (UBS´s) do município de Divinópolis, Minas Gerais. Foram divididos em dois grupos, os PEFR e NPEFR, e em seguida avaliados quanto a qualidade e presença de distúrbios do sono, percepção da insônia, e qualidade de vida, abordados de acordo com os respectivos questionários: Índice de Qualidade de Sono de Pittsburgh (IQSP), Índice de Gravidade de Insônia e Questionário de Qualidade de Vida SF-36. Quando comparado os grupos, houve diferença estatisticamente significativa quanto aos itens boa qualidade do sono, presença de insônia severa, qualidade de vida sob os domínios estado geral de saúde, aspectos sociais e saúde mental. Desta forma, sugere-se que os pacientes que praticam exercício físico regular assistidos em UBS’s apresentam maior prevalência de boa qualidade do sono, menor índice de insônia severa e melhor qualidade de vida.
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