Shruti M Paranjape1, Brian M McGinley2, Andrew T Braun3, Hartmut Schneider3. 1. Eudowood Division of Pediatric Respiratory Sciences, and sparanj1@jhmi.edu. 2. Division of Pediatric Pulmonary, Sleep Medicine, and Cystic Fibrosis, University of Utah, Salt Lake City, Utah. 3. Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland; and.
Abstract
BACKGROUND AND OBJECTIVES: Children with cystic fibrosis (CF) often report poor sleep, increased daytime sleepiness, and fatigue. The purpose of this study was to identify respiratory patterns over the spectrum of disease severity in children with CF. The overall hypothesis for the current study is that children with CF compared with snoring control subjects demonstrate gas exchange abnormalities and increased respiratory loads during sleep that are not reported or recognized by conventional polysomnography (PSG). METHODS: Analysis of breathing patterns and gas exchange on PSG was performed in children with CF and healthy controls matched by age and BMI. For all CF and control subjects, the indication for PSG was evaluation for obstructive sleep apnea based on a history of snoring. RESULTS: Children with CF, compared with age- and BMI-matched snoring controls, demonstrated lower oxyhemoglobin saturation (95% ± 1.6% vs 98% ± 0.6%, P = .005), higher respiratory rate (19.5 ± 4.9 vs 16.5 ± 1.2 breaths per minute, P = .03), and a higher proportion of inspiratory flow limitation (44.1% ± 24.7% vs 12.1% ± 13.5%, P = .007) during non-rapid eye movement sleep. The respiratory disturbance index did not differ between CF and snoring control groups (1.5 ± 2.7 vs 0.6 ± 0.6 events per hour, P = .11). CONCLUSIONS: Children with CF exhibited abnormalities in gas exchange and increased respiratory load during sleep compared with normal age- and BMI-matched snoring controls. Because these abnormalities were independent of weight and lung function, sleep state may serve as an opportunity for early detection of breathing abnormalities and possibly CF lung disease progression.
BACKGROUND AND OBJECTIVES:Children with cystic fibrosis (CF) often report poor sleep, increased daytime sleepiness, and fatigue. The purpose of this study was to identify respiratory patterns over the spectrum of disease severity in children with CF. The overall hypothesis for the current study is that children with CF compared with snoring control subjects demonstrate gas exchange abnormalities and increased respiratory loads during sleep that are not reported or recognized by conventional polysomnography (PSG). METHODS: Analysis of breathing patterns and gas exchange on PSG was performed in children with CF and healthy controls matched by age and BMI. For all CF and control subjects, the indication for PSG was evaluation for obstructive sleep apnea based on a history of snoring. RESULTS:Children with CF, compared with age- and BMI-matched snoring controls, demonstrated lower oxyhemoglobin saturation (95% ± 1.6% vs 98% ± 0.6%, P = .005), higher respiratory rate (19.5 ± 4.9 vs 16.5 ± 1.2 breaths per minute, P = .03), and a higher proportion of inspiratory flow limitation (44.1% ± 24.7% vs 12.1% ± 13.5%, P = .007) during non-rapid eye movement sleep. The respiratory disturbance index did not differ between CF and snoring control groups (1.5 ± 2.7 vs 0.6 ± 0.6 events per hour, P = .11). CONCLUSIONS:Children with CF exhibited abnormalities in gas exchange and increased respiratory load during sleep compared with normal age- and BMI-matched snoring controls. Because these abnormalities were independent of weight and lung function, sleep state may serve as an opportunity for early detection of breathing abnormalities and possibly CF lung disease progression.
Authors: Luciana O Palombini; Sergio Tufik; David M Rapoport; Indu A Ayappa; Christian Guilleminault; Luciana B M de Godoy; Laura S Castro; Lia Bittencourt Journal: Sleep Date: 2013-11-01 Impact factor: 5.849
Authors: Louise M O'Brien; Carolyn B Mervis; Cheryl R Holbrook; Jennifer L Bruner; Carrie J Klaus; Jennifer Rutherford; Troy J Raffield; David Gozal Journal: Pediatrics Date: 2004-07 Impact factor: 7.124
Authors: Albert M Li; Hugh S Lam; Michael H M Chan; Hung K So; Siu K Ng; Iris H S Chan; Christopher W K Lam; Yun K Wing Journal: Ann Acad Med Singapore Date: 2008-08 Impact factor: 2.473
Authors: Svenja Straßburg; Carolin-Maria Linker; Sebastian Brato; Christoph Schöbel; Christian Taube; Jürgen Götze; Florian Stehling; Sivagurunathan Sutharsan; Matthias Welsner; Gerhard Weinreich Journal: BMC Pulm Med Date: 2022-02-11 Impact factor: 3.317
Authors: Joel Reiter; Alex Gileles-Hillel; Malena Cohen-Cymberknoh; Dennis Rosen; Eitan Kerem; David Gozal; Erick Forno Journal: Sleep Med Rev Date: 2020-02-19 Impact factor: 11.609
Authors: Aarti Shakkottai; Samya Z Nasr; Fauziya Hassan; Sanaya Irani; Louise M O'Brien; Ronald D Chervin Journal: Sleep Med Date: 2020-06-05 Impact factor: 3.492
Authors: Christopher McNamara; Mahrya Johnson; Lisa Read; Heidi Vander Velden; Megan Thygeson; Meixia Liu; Laura Gandrud; John McNamara Journal: Evid Based Complement Alternat Med Date: 2016-12-19 Impact factor: 2.629
Authors: Don Hayes; Kevin C Wilson; Katelyn Krivchenia; Stephen M M Hawkins; Ian M Balfour-Lynn; David Gozal; Howard B Panitch; Mark L Splaingard; Lawrence M Rhein; Geoffrey Kurland; Steven H Abman; Timothy M Hoffman; Christopher L Carroll; Mary E Cataletto; Dmitry Tumin; Eyal Oren; Richard J Martin; Joyce Baker; Gregory R Porta; Deborah Kaley; Ann Gettys; Robin R Deterding Journal: Am J Respir Crit Care Med Date: 2019-02-01 Impact factor: 21.405