Sleep disturbances and their impact in pediatric cystic fibrosis

Shakkottai, Aarti; O’Brien, Louise M.; Nasr, Samya Z.; Chervin, Ronald D.

doi:10.1016/j.smrv.2018.07.002

Cited by 39 publications

(36 citation statements)

References 99 publications

(250 reference statements)

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“…This may reflect differences in preference for surgical therapy versus medical therapy in children and adults. Despite the known consequences of untreated sleep disturbances in the general population, recent reviews highlight the scarcity of data surrounding the treatment of sleep disorders in CF 6,22 . As discussed in one of these reviews, no studies have been conducted to evaluate the outcomes of adenotonsillectomy in children with CF and OSA 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Despite the known consequences of untreated sleep disturbances in the general population, recent reviews highlight the scarcity of data surrounding the treatment of sleep disorders in CF 6,22 . As discussed in one of these reviews, no studies have been conducted to evaluate the outcomes of adenotonsillectomy in children with CF and OSA 22 . Consensus guidelines are available for the treatment of nocturnal hypoxemia in adults with advanced CF lung disease, 23 but not specifically related to OSA.…”

Section: Discussionmentioning

confidence: 99%

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Sleep screening for cystic fibrosis patients: A survey of cystic fibrosis programs

Thomas

Brown

2020

Pediatric Pulmonology

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Objective The prevalence of sleep disorders in patients with cystic fibrosis (CF) is unknown, and no standardized screening or treatment guidelines exist to address sleep disorders in CF. The objective of this study is to characterize current sleep screening practices in adult, pediatric, combined, and affiliate CF programs. Methods A survey was developed in Research Electronic Data Capture and distributed to program directors of accredited CF programs in the United States. Results Eighty‐eight program directors responded (36% adult, 43% pediatric, 16% combined, 3% affiliate, and 1% unidentified). Of the respondents, 68% were part of an academic institution, 24% were associated with an academic institution, and 8% were part of a community or private program. Program sizes ranged from less than 50 to more than 500 patients. Routine or informal sleep screening was not performed in 44% of adults, 29% of pediatricians, and 35% of combined and affiliate programs. Most programs (>80%) have access to otolaryngology and sleep medicine although not all of these programs refer patients for evaluation of sleep disorders. Most program directors (77%) perceive sleep disorders as a problem in CF and would recommend routine sleep screening. Possible barriers to sleep screening included clinic flow, screening fatigue, and lack of recommendations for sleep screening. Conclusions Formal sleep screening is inconsistent among CF care centers although most survey respondents would recommend the inclusion of screening in routine CF care. Future work is needed to further evaluate the impact of sleep disorders in CF and determine best practices for standardization of sleep screening and treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sleep screening for cystic fibrosis patients: A survey of cystic fibrosis programs

Thomas

Brown

2020

Pediatric Pulmonology

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“…OSA in infants, children and adults are different entities in both the presentation and definitions according to the American Academy of Sleep Medicine (AASM) scoring manual 10,32 . People with CF may be inherently at risk for circadian rhythm disorders due to defective cystic fibrosis transmembrane regulator (CFTR) function in the hypothalamus, however CFTR has not been implicated in SDB and a genetic predisposition to SDB has not yet been identified in CF 33,34 . SDB can potentially be suspected by daytime oxygen saturation, nutritional status, and daytime sleepiness 5,35 .…”

Section: Sleep‐disordered Brreathing Across the Lifespanmentioning

confidence: 99%

Sleep‐disordered breathing in cystic fibrosis

Jagpal

Jobanputra

Ahmed

et al. 2021

Pediatric Pulmonology

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Sleep‐disordered breathing (SDB) is an under recognized comorbidity in the cystic fibrosis (CF) population across the lifespan. Nocturnal hypoxemia, obstructive sleep apnea, and nocturnal hypoventilation are respiratory abnormalities that occur commonly during sleep in patients with lung disease, and have deleterious consequences to the quality of life in people with CF. Effective screening for these abnormalities is needed to allow for timely initiation of treatment, which has been reported to be efficacious. Lack of treatment leads to worsened pulmonary, cardiovascular, and metabolic outcomes in patients. In this review, we give an overview of SDB for the CF clinician, including prevalence, treatment, and suggestions for future research. We strongly encourage the CF community to incorporate evaluation for SDB in CF clinical care so that outcomes for the subset of the CF patients with comorbid SDB improve.

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“…Children and adults with CF who report poor subjective sleep quality also report reduced quality of life [ 48 ], especially among the adolescents, including physical, social and emotional functioning; vitality; and health perception [ 45 ]. Poor mood is another consequence of inadequate sleep among CF children [ 49 ].…”

Section: Psychological Symptoms and Neuronal Impairment In Cfmentioning

confidence: 99%

Impact of Physical Activity on Cognitive Functions: A New Field for Research and Management of Cystic Fibrosis

et al. 2020

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Cystic Fibrosis (CF) is a genetic disease inherited by an autosomal recessive mechanism and characterized by a progressive and severe multi-organ failure. Mutations in Cystic Fibrosis Conductance Regulator (CFTR) protein cause duct obstructions from dense mucus secretions and chronic inflammation related to organ damage. The progression of the disease is characterized by a decline of lung function associated with metabolic disorders and malnutrition, musculoskeletal disorders and thoracic deformities, leading to a progressive decrement of the individual’s quality of life. The World Health Organization (WHO) qualifies Physical Activity (PA) as a structured activity produced by skeletal muscles’ movements that requires energy consumption. In the last decade, the number of studies on PA increased considerably, including those investigating the effects of exercise on cognitive and brain health and mental performance. PA is recommended in CF management guidelines, since it improves clinic outcomes, such as peripheral neuropathy, oxygen uptake peak, bone health, glycemic control and respiratory functions. Several studies regarding the positive effects of exercise in patients with Cystic Fibrosis were carried out, but the link between the effects of exercise and cognitive and brain health in CF remains unclear. Animal models showed that exercise might improve learning and memory through structural changes of brain architecture, and such a causal relationship can also be described in humans. Indeed, both morphological and environmental factors seem to be involved in exercise-induced neural plasticity. An increase of gray matter volume in specific areas is detectable as a consequence of regular training in humans. Neurobiological processes associated with brain function improvements include biochemical modifications, such as neuromodulator or neurohormone release, brain-derived neurotrophic factor (BDNF) production and synaptic activity changes. From a functional point of view, PA also seems to be an environmental factor enhancing cognitive abilities, such as executive functions, memory and processing speed. This review describes the current state of research regarding the impacts of physical activity and exercise on cognitive functions, introducing a possible novel field of research for optimizing the management of Cystic Fibrosis.

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Sleep disturbances and their impact in pediatric cystic fibrosis

Cited by 39 publications

References 99 publications

Sleep screening for cystic fibrosis patients: A survey of cystic fibrosis programs

Sleep screening for cystic fibrosis patients: A survey of cystic fibrosis programs

Sleep‐disordered breathing in cystic fibrosis

Impact of Physical Activity on Cognitive Functions: A New Field for Research and Management of Cystic Fibrosis

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