0844 Sleep-Disordered Breathing in Cystic Fibrosis. (12th April 2019)

• Record Type: Journal Article
• Authors: Shakkottai, Aarti; O'Brien, Louise M; Nasr, Samya Z; Chervin, Ronald D
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A339
• Page End: A339
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.842
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Cystic fibrosis (CF) is a lethal, genetic disease that affects approximately 30, 000 Americans. Patients frequently report snoring, mouth breathing, and insomnia. Yet, the extent to which sleep-disordered breathing (SDB) may underlie these complaints remains unknown. Methods: Single-center retrospective review of polysomnography results from referred patients with CF (cases), including 29 children and 23 adults, and referred non-CF patients (controls) individually-matched (1:2) for age, gender, race, and body mass index (BMI). Results: Mean ages were 8±5.1(sd) and 36±12.8 years, among the children and adults respectively. Mean BMI %tile was 61±29% among children. Mean BMI in adults was 25±5 kg/m 2 . Approximately 60% of cases and controls proved to have SDB (Chi-square test, p=0.82). However, pediatric cases, in comparison to controls, had 3.5 times greater odds of having moderate-severe SDB (as defined by apnea-hypopnea index (AHI) > 5; conditional logistic regression, p=0.04). Adult cases vs. controls had a similar (3.3) though non-significantly greater odds of having moderate-severe SDB (AHI ≥ 15; p=0.1). The oxygen saturation nadir was 88%, on average, for cases and 90% for controls (Wilcoxon rank sum test, p=0.002). Cumulative duration of hypoxemia (oxygen saturation <90% or <88% for children or adults, respectively), was worse among the cases vs. controls (5.81 vs. 0.39 minutes, p=0.005). Cases also had a 7 times greater odds, as compared to controls, of experiencing hypoxemia for a cumulative overnight total of ≥5 minutes (p=0.02). Among subjects with CF, the forced expiratory volume in 1 second (FEV1) %predicted, a marker of lung disease severity, was significantly associated with the nocturnal oxygen saturation nadir (Pearson correlation, r=0.56, p=0.0001) but not AHI (r=-0.17, p=0.27). However, both AHI and FEV1 %predicted showed independent associations with the nocturnal oxygen saturation nadir (Linear regression, FEV1: β=0.07, SE= 0.02, p=0.0002; AHI: β=-0.24, SE= 0.08, p=0.0047). Conclusion: Severity of SDB may be worse among referred patients with CF as compared to matched patients without CF. Moreover, severity of SDB may predict nocturnal hypoxemia, a known risk factor for pulmonary hypertension and mortality, independent of lung disease severity. Support (If Any): NIH Training Grant (T32NS007222)