Sleep‐disordered breathing in cystic fibrosis

Jagpal, Sugeet; Jobanputra, Aesha; Ahmed, Omar; Santiago, Teodoro V.; Ramagopal, Maya

doi:10.1002/ppul.25028

Cited by 9 publications

(5 citation statements)

References 116 publications

(170 reference statements)

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“…Although the AHI of the entire population in this study was normal, consistent with existing literature [ 13 , 21 , 24 , 32 ], there was a high prevalence of OSA (AHI ≥ 5/h). Comparing our data with the available literature is challenging, because study designs and patient selection are heterogenous with respect to age, lung function, BMI and sample size, and PSG studies examining an exclusively adult CF population are rare [ 7 , 33 ]. Published data regarding the prevalence of OSA in adult pwCF report a prevalence of 3.2–3.9% [ 13 , 32 ], substantially lower than the 40% in our study.…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea and nocturnal hypoxemia in adult patients with cystic fibrosis

et al. 2022

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Background Obstructive sleep apnea (OSA), nocturnal hypoxemia and excessive daytime sleepiness (EDS) are common comorbidities in people with cystic fibrosis (pwCF). Most of the data showing this originates from children and adolescents. The aim of this study was to collect data on sleep parameters, EDS and pulmonary function from a large cohort of adult pwCF. Methods Full overnight polysomnography (PSG) was performed. EDS was determined using the Epworth Sleepiness Scale (ESS). Demographic and clinical data (body mass index [BMI], pulmonary function, capillary blood gases) were collected. Results A total of 52 adult pwCF were included (mean age 30.7 ± 8.0 years, mean percent predicted forced expiratory volume in 1 s [ppFEV1] of 52.1 ± 14.8). Overall AHI was in the normal range (4.5 ± 4.0/h); 21/52 pwCF (40%) had an apnea-hypopnea index > 5/h. Nocturnal hypoxemia was found in 25% of participants and this was associated with ppFEV1 (p = 0.014), awake oxygen saturation (SpO2; p = 0.021) and awake partial pressure of oxygen (pO2; p = 0.003); there were no significant differences in age, lung function and BMI were found for pwCF with versus without OSA (all p > 0.05). Eight pwCF (15%) had an ESS score > 10 (indicating EDS). OSA was best predicted by awake pO2 (area under the curve [AUC] 0.66, p = 0.048), while nocturnal hypoxemia was best predicted by ppFEV1 (AUC 0.74, p = 0.009), awake pO2 (AUC 0.76, p = 0.006) and awake SpO2 (AUC 0.71; p = 0.025). Conclusion OSA, nocturnal hypoxemia and EDS were common in adult pwCF, but no strong predictors were identified. Therefore, we suggest regular PSG and ESS scoring in adult pwCF, regardless of disease severity.

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Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea and nocturnal hypoxemia in adult patients with cystic fibrosis

et al. 2022

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“…Sleep-disordered breathing (SDB) encompasses OSA which is due to intermittent collapse of the upper airway during sleep, central sleep apnea (CSA) which is due to the intermittent absence of respiratory effort during sleep, as well as hypoventilation, which may occur in persons with CF from various mechanisms. 11,12 Early studies often reported on SDB without differentiating between SDB patterns and since OSA is the most common SDB pattern, the term OSA will be used in describing these studies. 13,14 The intermittent collapse of the upper airway during sleep in OSA leads to breathing pauses and may cause oxygen desaturation and sleep fragmentation.…”

Section: Obstructive Sleep Apnea (Osa)mentioning

confidence: 99%

Overnutrition in persons with cystic fibrosis on modulator therapy and the relationship to obstructive sleep apnea

Jobanputra,

Kesavarapu,

Naik

et al. 2024

Pediatric Pulmonology

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Cystic fibrosis (CF) care is evolving with the ubiquitous use of modulator therapy and resultant increase in lifespan. It is important for CF clinicians to monitor the pathologic weight gain that is concomitantly being seen as obesity is a known risk factor for multiple other diseases. In this review we focus on obesity in CF, discuss screening and lifestyle considerations, outline CF‐specific concerns with weight loss medications, and describe the vicious cycle of obesity and obstructive sleep apnea (OSA). We discuss screening and treatment for OSA, as it directly correlates with weight fluctuation. We offer interim recommendations for CF teams as they continue to care for this population.

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“…Furthermore, different from patients with bronchiectasis and mycobacterial infections, patients with CF often manifest poor sleep quality with frequent awakenings and daytime sleepiness, and such disturbances are more frequent with the progression of the disease [ 68 ]. Despite this, SDB prevalence is still under-recognized in this population of patients and may impact disease outcomes [ 69 ]. As an example, in CF patients with a severe disease complicated by pulmonary hypertension and right ventricular failure, chronic nocturnal hypoxia secondary to untreated SDB may worsen the disease leading to a poor prognosis [ 70 ].…”

Section: Sleep-disordered Breathing and Cystic Fibrosismentioning

confidence: 99%

Sleep-Disordered Breathing and Chronic Respiratory Infections: A Narrative Review in Adult and Pediatric Population

Faverio

Zanini

Monzani

et al. 2023

IJMS

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Sleep-disordered breathing (SDB) comprises different diseases characterized by abnormal respiratory patterns during sleep including obstructive sleep apnea. SDB prevalence and impact in patients with chronic respiratory infections have been only marginally studied. The purpose of this narrative review is to report the prevalence and impact of SDB in chronic respiratory infections, including cystic fibrosis (CF), bronchiectasis and mycobacterial infections, and explore the possible pathophysiological mechanisms. Common pathophysiological mechanisms, underlying SDB onset in all chronic respiratory infections, include inflammation, which plays a central role, chronic nocturnal cough and pain, excessive production of mucous plugs, presence of obstructive and/or restrictive ventilatory impairment, upper airways involvement, and comorbidities, such as alteration of nutritional status. SDB may affect about 50% of patients with bronchiectasis. The severity of the disease, e.g., patients colonized with P. aeruginosa and frequent exacerbators, as well as comorbidities, such as chronic obstructive pulmonary disease and primary ciliary dyskinesia, may impact SDB onset. SDB may also frequently complicate the clinical course of both children and adults with CF, impacting the quality of life and disease prognosis, suggesting that their routine assessment should be incorporated into the clinical evaluation of patients from the first stages of the disease regardless of suggestive symptoms, in order to avoid late diagnosis. Finally, although the prevalence of SDB in patients with mycobacterial infections is uncertain, extrapulmonary manifestations, particularly nasopharyngeal locations, and concomitant symptoms, such as body pain and depression, may act as atypical predisposing factors for their development.

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Sleep‐disordered breathing in cystic fibrosis

Cited by 9 publications

References 116 publications

Obstructive sleep apnea and nocturnal hypoxemia in adult patients with cystic fibrosis

Obstructive sleep apnea and nocturnal hypoxemia in adult patients with cystic fibrosis

Overnutrition in persons with cystic fibrosis on modulator therapy and the relationship to obstructive sleep apnea

Sleep-Disordered Breathing and Chronic Respiratory Infections: A Narrative Review in Adult and Pediatric Population

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