Chest
Clinical InvestigationsSleep and BreathingPredictability of Oxygen Desaturation During Sleep in Patients With Cystic Fibrosis: Clinical, Spirometric, and Exercise Parameters
Section snippets
Sample
Seventy adult patients with CF (age range, 17 to 53 years),equally distributed for gender and severity of lung disease (ascharacterized with % pred, FEV1) participated inthe study (Table 1). Details of the experimental procedures and an explanation of therisks involved were provided for each subject before obtaining writtenconsent. The study was approved by the Ethics Committee of the, University of British Columbia and St. Paul's Hospital. Patientsunderwent a battery of tests that included
Results
The study sample consisted of 70 CF patients with heterogeneousdisease severity. Table 1 presents some overall clinical statusparameters and the age and gender distribution of the study sample. Spo2 is presented during rest, sleepand maximal exercise, as well as, o2max in Table 2with patients grouped by disease severity according to% pred, FEV1 into mild(% pred, FEV1 > 70%), moderate(% pred, FEV1 from 50 to 70%) and severe(% pred, FEV1 < 50%) pulmonary disease. According to pulmonary function
Discussion
Nocturnal oxygen desaturation was commonly observed in ourpopulation of adult CF patients. Approximately 40% of a representativegroup of our clinic had Spo2 valuesof < 90% for > 5% of the night. Although the threshold ofnocturnal desaturation that is physiologically significant in CFpatients remains unclear, adverse outcomes in right ventricularhemodynamics and survival in patients who have COPD have been reportedat comparable levels.1314 The degree of nocturnaldesaturation correlated with
References (19)
- et al.
Nocturnal hypoxemia in CF: relationship to pulmonary function tests
Respir Med
(1994) - et al.
Survival in COPD patients with daytime Pao2> 60 mm Hg with and without nocturnal oxyhemoglobin desaturation
Chest
(1992) - et al.
Postural hypoxemia in cystic fibrosis
Chest
(1985) Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial
Ann Intern Med
(1980)Long-term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema
Lancet
(1981)- et al.
Changes in nocturnal oximetry after treatment of exacerbations in CF
Arch Dis Child
(1993) - et al.
Relationship between airway obstruction, desaturation during exercise and nocturnal hypoxemia in cystic fibrosis patients
Eur Respir J
(1990) Standardization of Spirometry, 1994 update
Am J Respir Crit Care Med
(1995)- et al.
Maximal and ventilatory threshold responses to treadmill, and water immersion running
J Med Sci Sports Exerc
(1995)
Cited by (54)
Sleep disorders in cystic fibrosis: A systematic review and meta-analysis
2020, Sleep Medicine ReviewsSleep disturbances and their impact in pediatric cystic fibrosis
2018, Sleep Medicine ReviewsCitation Excerpt :Unlike in adults with the disease where the degree of hypoxemia during sleep has been shown to be worse than that observed during exercise [44], in children with CF the oxygen nadir during sleep and exercise appear to be similar [52]. In both children and adults, oxygen levels during sleep have been shown to vary with awake resting oxygen saturation and markers of CF lung disease severity such as FEV1% predicted, Schwachman-Kulczycki clinical disease severity score, and findings on chest radiography and computed tomography [26,27,30,38,41,50–54]. An awake resting oxygen saturation <94% (Fig. 2) or an FEV1% predicted < 64% may predict likelihood of nocturnal hypoxemia to an extent that could be clinically useful [38,41,52].
Respiratory sleep disturbance in children and adolescents with cystic fibrosis
2016, Revista Portuguesa de PneumologiaCitation Excerpt :To the best of our knowledge this is the first study in a CF Portuguese Paediatric population to evaluate sleep disturbance and to try to relate it to spirometric indices, a clinical diagnostic and prognostic relevant endpoint.16 There are some studies involving adult CF patients and CF children but only during acute illness or with higher clinical severity.1,7,13,31 Most studies presented limitations such as small population samples, sleep assessment performed only through sleep questionnaires and/or evaluated by pulse oximetry analysis.6,15,32
Cystic fibrosis and sleep
2014, Clinics in Chest MedicineRecommendations for long-term home oxygen therapy in children and adolescents
2013, Jornal de Pediatria