Predictors of sleep hypoxemia in children with cystic fibrosis. Issue 3 (4th January 2019)

• Record Type: Journal Article
• Authors: Isaiah, Amal; Daher, Amine; Sharma, Preeti B.; Naqvi, Kamal; Mitchell, Ron B.
• Is Part Of: Pediatric pulmonology. Volume 54:Issue 3(2019)
• Page Start: 273
• Page End: 279
• Publication Date: 2019-01-04
• Subjects: cystic fibrosis -- pulmonary function testing -- sleep medicine; Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.24233
• Languages: English
• ISSNs: 8755-6863

Abstract

Abstract: Objectives: To identify the determinants of nocturnal hypoxemia in children with CF using clinical parameters, polysomnography (PSG), and lung function. Hypothesis: Sleep hypoxemia in children with CF is predicted by both apnea hypopnea index (AHI) and percent predicted forced expiratory volume in one second (pFEV1). Design: Retrospective case series. Methods: Children aged 5‐18 years were included based on (i) a diagnosis of CF; and (ii) availability of concurrent PSG and pFEV1 data. The impact of (i) demographic and clinical parameters; and (ii) PSG and pFEV1, on the total sleep time spent with arterial oxygen saturation below 90% (TSpO2 < 90) was measured using regression analysis. P ‐value <0.05 was considered significant. Results: The mean age was 11.6 years (95% confidence interval: 9.5, 13.1). Twenty of 35 (57%) were boys and the mean body mass index percentile was 42.1 (31.5, 52.6). The most common ethnicity was white (66%). OSA was diagnosed in 50%. Neither demographic predictors nor clinical variables predicted the severity of hypoxemia ( R 2 = 0.23, P = 0.09). While pFEV1 and PSG variables accounted for significant proportion of the overall variance in TSpO2 < 90 ( R 2 = 0.53, P < 0.001), pFEV1 was identified as the single best predictor of sleep hypoxemia. A pFEV1 cut‐off of 53% indicated a sensitivity of 0.80 and a specificity of 0.87 in predicting sleep hypoxemia. Conclusions: pFEV1 is the best predictor of sleep hypoxemia in children with CF and referred for PSG. No demographic or clinical predictors of hypoxemia were identified in this population.