Sleep‐disordered breathing and markers of morbidity in children and adolescents with cystic fibrosis

Abstract

Background: Studies have shown that sleep disorders occur in cystic fibrosis (CF) patients and may be present before daytime clinical manifestations.Objectives: To evaluate the presence of sleep disorders among children and adolescents with CF, attempting to identify associations with pulmonary function, nutritional status, days in hospital, and days taking antibiotics.Methods: Individuals with a diagnosis of CF aged between 6 and 18 years were included. Information on sociodemographic, clinical profile, history of hospitalizations, and use of antibiotics in the last year were collected. Spirometry, bioimpedance, and polysomnography were performed. The presence of nocturnal hypoxemia and obstructive sleep apnea syndrome (OSAS) were evaluated and participants divided according to their presence.Results: Thirty-one patients were included. The prevalence of OSAS was 32.3% and nocturnal hypoxemia was 29.0%. Average nocturnal peripheral oxyhemoglobin saturation (SpO 2 ) correlated (P < .001) with forced vital capacity (r = .55) and forced expiratory volume in the first second (r = .62). The higher the percentage of total sleep time (TST) with SpO 2 less than 90%, the lower the pulmonary function.Individuals with OSAS and nocturnal hypoxemia had lower spirometric values compared to patients without these disorders, but the nocturnal hypoxemia group also had lower Shwachman-Kulczycki score, longer hospitalization time and antibiotic use. TST with SpO 2 less than 90% was associated with length of hospitalization (r 2 = .53). Conclusion:Children and adolescents with CF have sleep disorders, including OSAS (32.3%) and nocturnal hypoxemia (29%). Individuals with nocturnal hypoxemia presented lower lung function, worse clinical score, and higher morbidity. TST with SpO 2 less than 90% was associated with length of hospitalization.

Sleep disturbances in children with cystic fibrosis, primary ciliary dyskinesia and typically developing children during COVID‐19 pandemic

“…Although some studies have associated SDB with pulmonary function parameters in children with CF, no such correlation has yet been established for patients with PCD 6,29–32 . Likewise, we did not find any associations between sleep disorders and clinical parameters of children with lung disease.…”

Adherence and barriers to general and respiratory exercises in cystic fibrosis

“…However, other studies 18,19 have indicated that patients with CF tend to lessen the importance of exercises on daily routine and, therefore, adherence to exercises are lower compared with pancreatic enzymes and antibiotics therapies. [19][20][21] The purpose of this study was to describe the level of adherence and the barriers to general and respiratory exercises reported by individuals diagnosed with CF. The specific research questions were: The findings may help the identification of individuals with CF who are less likely to exercise and, therefore, help guide clinical practice by suggesting strategies to increase adherence to exercises.…”

Sleep‐disordered breathing in cystic fibrosis

“…The frequency of OSA is high among young children with CF, and the presence of both these conditions together is associated with lower nocturnal oxygen saturations than in children with CF alone 16 . A recent study demonstrated that the prevalence of OSA and nocturnal hypoxemia in CF is close to 30% in children and adolescents 40 …”

“…It is important to note that the definition of hypoxemia varies in studies in the literature, but the AASM defines nocturnal hypoxemia as oxygen saturation ≤90% in children and ≤88% in adults for >5 minutes 32 . Higher total sleep time spent with oxygen saturation of <90% is associated with worse pulmonary function in children 40 …”