Insomnia in adults with cystic fibrosis: strong association with anxiety/depression and impaired quality of life

Abstract

Background While sleep disruption is a common complaint among children with cystic fibrosis (CF), only a few studies have investigated insomnia in adults. The aim of this study was to identify factors associated with insomnia in clinically stable adult CF patients. Methods Twenty-eight CF patients (18M/10F), with a median age of 27 (22–34) (median (interquartile range) years and a median of forced expiratory volume in one second of 72 (39–93) % predicted completed questionnaires on insomnia (Insomnia Severity Index, ISI), sleep quality (PSQI), daytime sleepiness (Epworth), restless legs syndrome (IRLS), pain (NRS), anxiety/depression (HAD) and quality of life (CFQ-R 14+). Respiratory assessment data, including symptoms, sputum analysis, arterial blood gases, 6-min walking test, pulmonary function tests and polysomnographic variables, were also analyzed. Results Forty-three percent of patients were insomniac (ISI > 7). Compared with non-insomniac patients (ISI ≤ 7), insomniac patients had more severely impaired quality of life and a higher HAD score: median anxiety score of 9 (8–11) vs 4 (3–6) (p < 0.0001), median depression score of 7 (5–10) vs 1 (1–4) (p < 0.001), with a positive correlation between ISI and HAD anxiety/depression scores (r = 0.702/r = 0.701, respectively, p < 0.0001). Insomnia was also associated with mMRC dyspnea scale ≥ 2, restless legs syndrome, pain and lower SpO2 during sleep. Conclusions The strong association between insomnia, impaired quality of life and increased HAD score should prompt physicians to be particularly attentive to the management of anxiety and depression in adult CF patients with insomnia. Trial registration: On clinicaltrials.gov (NCT02924818, date of registration: October 5, 2016).

Prevalence of Sleep Disturbance in Patients With Cancer: A Systematic Review and Meta-Analysis

“…The aggregate prevalence of sleep disturbance in patients with cancer was 60.7%, which suggests that at least more than half of the cancer patients experience sleep disturbance. Those results are even higher when compared with sleep disturbance prevalence in other diseases such as cardiovascular (36.5%) (Edmealem et al, 2020), (37%) irritable bowel syndrome (Wang et al, 2018), diabetes (47%) (Birhanu et al, 2020), and cystic fibrosis (43%) (Mulette et al, 2021). Moreover, Simonelli et al (2018), who conducted meta-analyses including 45 studies of low and middle-income countries from the general population, estimated the prevalence of sleep disturbance to be 32%.…”

Predicting anxiety, depression, and insomnia among Bangladeshi university students using tree‐based machine learning models

“…The categorized levels of insomnia are No clinically significant Insomnia, Subthreshold insomnia, Clinical insomnia (moderate severity), and Clinical insomnia (severe) based on the scores 0−7, 8−14,15−21, and 22−28, respectively 60 . This study used a cutoff score of >7 as the presence of insomnia among the students 61 . The Cronbach's α values indicate that the questionnaire is reliable (0.959).…”

“…The ISI-7 is made up of seven items that assess 60 This study used a cutoff score of >7 as the presence of insomnia among the students. 61 The Cronbach's α values indicate that the questionnaire is reliable (0.959).…”