Quality of life in clinically stable adult cystic fibrosis out-patients: Associations with daytime sleepiness and sleep quality

Abstract

Background: Patients with cystic fibrosis (CF) may suffer from sleep disturbances and reduced health-related quality of life (HRQoL). However, the relationships of daytime sleepiness and sleep quality to HRQoL in CF have not yet been investigated. Patients and methods: 55 adult CF outpatients free from a pulmonary exacerbation were prospectively enrolled in this study. Questionnaires were used to assess disease-specific HRQoL (German version of the revised Cystic Fibrosis Questionnaire for adults, CFQ18 þ R), daytime sleepiness (Epworth Sleepiness Scale, ESS) and sleep quality (Pittsburgh Sleep Quality Index, PSQI). 30 age-and sex-matched healthy volunteers served as a control group. Results: The prevalence of daytime sleepiness was higher in the CF than in the control group (ESS > 10; n Z 11 [20%] vs. n Z 2 [6.7%]; p < 0.01) as was reduced sleep quality (PSQI > 5; n Z 21 [38.2%] vs. n Z 1 [3.3%]; p < 0.01). Multiple regression analysis including age, gender, body mass index, lung function and pseudomonas status showed that higher PSQI scores significantly correlated with lower CFQ18 þ R scores for vitality, emotional functioning, social, role, eating disturbances and digestive symptoms. Conclusion: In clinically stable adult CF outpatients self-reported daytime sleepiness and poor sleep quality are more common than in age and sex-matched healthy controls. In addition, impaired sleep quality is related to reduced disease-specific HRQoL in CF.

Evaluation of selected insomnia predictors in adolescents and young adults with cystic fibrosis

“…The results of our study and those obtained by Bouka et al 7 demonstrate that insomnia significantly lowers the quality of life. It is therefore important to quickly diagnose and treat this disorder, both for the comfort of CF patients' life and for socio-economic costs 44 .…”

“…The widespread prevalence of this problem has been observed in paediatric and adolescent patients 31 , as well as in adults with CF 32 . Researchers point out that patients with CF have worse quality of sleep than healthy individuals 7,32,33 . The progression of bronchial-pulmonary disorders and the presence of other comorbidities further lower the quality of sleep in CF patients.…”

“…Scientific reports on sleep quality in patients with CF indicate the widespread prevalence of sleep disorders in this group of patients 4 , with simultaneous undesirable effects on many areas of physical and mental functioning [5][6][7][8] . Although factors that improve the quality of sleep and the condition of the body are being sought and implemented (e.g.…”

Relationship Between Clinical Variables and Health-Related Quality of Life in Young Adult Subjects With Cystic Fibrosis

“…Regarding the WHOQOL-BREF questionnaire, we observed a correlation between 3 domains (physical, social relationships, and environment). However, Bouka et al 36 observed that higher PSQI scores correlated with lower scores in the vitality, emotional functioning, social, and role domains. Still, in relation to sleep quality, statistical analysis showed that daytime sleepiness, as evaluated by the ESS, was significantly related to the psychological domain in the WHOQOL-BREF questionnaire.…”

“…At baseline, we found that lung function and nutritional status were similar to those in prior studies. 11,[36][37][38] These factors surely have had a great impact on HRQOL outcomes.…”