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DOI: 10.1055/s-0034-1367939
Predictors of Sleep-Disordered Breathing in Lung Transplant Recipients
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.