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

Abstract

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.

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

“…Impaired sleep and SDB may have a variety of consequences in pwCF, including reduced health-related quality of life (HRQoL) [ 20 , 23 ], increased daytime sleepiness [ 20 , 24 ], reduced neurocognitive function [ 24 ], development of pulmonary hypertension [ 25 ], or reduced physical activity [ 26 ]. Despite the knowledge that SDB is a common comorbidity in pwCF and its negative impact on different aspects of the disease, most CF centers do not screen routinely for SDB [ 27 ]. Recent reviews highlighted the significant impact of SDB for pwCF.…”

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

“…30 The questionnaires utilized were the Munich Chronotype Questionnaire (MCTQ), which is used primarily to collect sleep schedules and Pediatric Sleep Questionnaire (PSQ), which is used in pediatric population suspected of having OSA. 30 No formal questionnaires used to assess OSA in adults were reported in the study. 30 Presently, United States Preventive Services Task Force (USPSTF) guidelines state that there is insufficient evidence to screen for OSA in adults who are at low risk or do not have signs or symptoms of OSA.…”

“…30 No formal questionnaires used to assess OSA in adults were reported in the study. 30 Presently, United States Preventive Services Task Force (USPSTF) guidelines state that there is insufficient evidence to screen for OSA in adults who are at low risk or do not have signs or symptoms of OSA. 31 On the other hand, the American Academy of Sleep Medicine (AASM) states it is imperative to identify adults with symptoms of OSA such as snoring, excessive daytime sleepiness, or witnessed pauses in breathing.…”

“…Presently, there are no guidelines available for screening pwCF for OSA. A study by Thomas and colleagues sought to characterize current sleep screening practices in CF programs across the nation using an online survey, to which approximately 50% of the programs responded 30 . The study demonstrated that sleep screening varied drastically across different programs 30 .…”

Cystic fibrosis year in review 2020: Section 2 pulmonary disease, infections, and inflammation

“…Multiple articles addressed sleep concerns in both CF patients and caregivers. A survey of US CF center directors (50% response rate) queried the formality and frequency of clinical sleep assessments 13 . Of the 88 respondents, about 69% of pediatric and 56% of adult centers screened for sleep symptoms in some manner.…”