Pneumologie 2014; 68 - V622
DOI: 10.1055/s-0034-1367939

Predictors of Sleep-Disordered Breathing in Lung Transplant Recipients

U Sommerwerck 1, B Kleibrink 2, F Kruse 1, Y Wang 1, M Kamler 3, H Teschler 1, G Weinreich 4
  • 1Abteilung Pneumologie-Universitätsklinik, Ruhrlandklinik, Westdeutsches Lungenzentrum, Universitätsklinik Essen, Universität Duisburg-Essen, Essen
  • 2Ruhrlandklinik; Westdeutsches Lungenzentrum; Universitätsklinikum Essen
  • 3Abteilung für Thorakale Transplantationschirurgie; Westdeutsches Herzzentrum; Universitätsklinikum Essen
  • 4Resmed Science Center; Abteilung Pneumologie-Universitätsklinik,Ruhrlandklinik, Westdeutsches Lungenzentrum, Universitätsklinik Essen, Universität Duisburg-Essen, Essen

Study Objectives: Only a few studies with small sample size analyzed sleep-disordered breathing (SDB) in patients after lung transplantation (LuTX). The aim of our study was to test the hypothesis that SDB prevalence is high and pre-transplant COPD is an independent predictor of SDB in LTX.

Design: Cross-sectional study

Setting: Sleep laboratory

Patients or participants: We studied 53 clinically stable lung transplant recipients (31 men, time range after LuTX 9 months to 10 years). Indications for LTX were: 25 COPD, 15 idiopathic pulmonary fibrosis, 6 cystic fibrosis, 7 others.

Interventions: Polysomnography (PSG) was performed to investigate sleep characteristics. SDB was defined by an apnea-hypopnea index (AHI) ≥10/h. Daytime sleepiness was measured by the Epworth Sleepiness Scale (ESS).

Measurements and Results: The prevalence of SDB was 53% (45% OSA, 8% CSA). The prevalence in a subgroup of pretransplant patients with COPD was 71%. Univariate analysis showed that SDB was significantly associated with age> 50 years (odds ratio (OR)= 3.61, 95% confidence interval (CI)= 1.04 – 12.60), BMI> 25 kg/m2 (OR = 3.17, 95%CI = 1.03 – 9.77), male gender (OR = 3.18, 95%CI = 1.02 – 9.93), neck circumference per 1-cm size increment (OR = 1.33, 95%CI = 1.11 – 1.60) and pre-transplant COPD vs. other diseases(OR = 8.91, 95%CI = 1.89 – 41.99). However, in a multivariate analysis only neck circumference (OR = 1.30, 95%CI = 1.06 – 1.58) and pre-transplant COPD (OR = 9.73, 95%CI = 1.53 – 61.73) remained independently associated with SDB.

Conclusions: The prevalence of SDB is high in stable lung transplant recipients. COPD prior to lung transplantation and neck circumference thereafter are independent predictors of SDB.