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

• DOI: 10.1186/s12890-022-02243-0
• Publication Date: 2022-11-28T04:30:16Z
• Authors: Matthias Welsner; Sarah Dietz-Terjung; Florian Stehling; Tim Schulte; Ute Niehammer; Fatma-Ezzahra Gah...; Christian Taube; Svenja Strassburg; Christoph Schoebel; Gerhard Weinreich; Sivagurunathan Su...
• Keywords: Adult; Adolescent; Cystic Fibrosis; Medizinische Fakultät » Universitätsklinikum Essen » Ruhrlandklinik Essen – Universitätsklinik; Polysomnography; Medizin; 610; Disorders of Excessive Somnolence; Cystic fibrosis; Diseases of the respiratory system; Young Adult; 03 medical and health sciences; 0302 clinical medicine; 616; Adults; Humans; ddc:610; Cystic fibrosis -- Adults -- Polysomnography -- Excessive daytime sleepiness -- Apnea-hypopnea index -- Obstructive sleep apnea -- Nocturnal hypoxemia; Child; Hypoxia; ddc:610; Sleep Apnea, Obstructive; RC705-779; Excessive daytime sleepiness; Research; Obstructive sleep apnea; 3. Good health; Apnea-hypopnea index; ScholarlyArticle

Abstract 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.