Sleep‐disordered breathing in cystic fibrosis

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

doi:10.1002/ppul.25028

Cited by 6 publications

(4 citation statements)

References 116 publications

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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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“…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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“…[32][33][34] The American Academy of Sleep Medicine recommends that polysomnography be used for objective testing in patients with primary pulmonary disease for accurate assessment, as indicated above. 35,36 While obstructive sleep apnea is commonly seen, polysomnography is essential to identify additional forms of sleep-disordered breathing, including central sleep apnea or hypoventilation. 37 Wheeler et al 38 published work to highlight the differences in central apnea syndrome etiologies in adults and children.…”

Section: Utility Of Polysomnography In Assessing Sleep-disordered Bre...mentioning

confidence: 99%

“…Polysomnography can also help assess sleep fragmentation, which has been associated with worse quality of life, excessive daytime sleepiness, and increased metabolic dysfunction and inflammation 32–34 . The American Academy of Sleep Medicine recommends that polysomnography be used for objective testing in patients with primary pulmonary disease for accurate assessment, as indicated above 35,36 . While obstructive sleep apnea is commonly seen, polysomnography is essential to identify additional forms of sleep‐disordered breathing, including central sleep apnea or hypoventilation 37 .…”

Section: Utility Of Polysomnography In Assessing Sleep‐disordered Bre...mentioning

confidence: 99%

Pediatric pulmonary year in review 2021: Sleep medicine

Okorie

Afolabi‐Brown

Tapia

2022

Pediatric Pulmonology

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Pediatric pulmonology publishes original research, review articles, and case reports on a wide variety of pediatric respiratory disorders. In this article, we summarized the past year's publications in sleep medicine and reviewed selected literature from other journals in this field. We focused on original research articles exploring aspects of sleep‐disordered breathing in patients with underlying conditions such as cystic fibrosis, asthma, and sickle cell disease. We also explored sleep‐disordered breathing risk factors, monitoring, diagnosis, and treatment; and included recent recommendations for drug‐induced sleep endoscopy and ways to monitor and improve PAP adherence remotely.

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Sleep‐disordered breathing in cystic fibrosis

Cited by 6 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

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

Pediatric pulmonary year in review 2021: Sleep medicine

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