Sleep-disordered breathing in cystic fibrosis.
Sleep-disordered breathing in cystic fibrosis.
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DOI：
10.1016/j.sleep.2020.05.031
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发表时间：
2020-10
期刊：
影响因子：
4.8
通讯作者：
Chervin RD
中科院分区：
文献类型：
--
作者：
Shakkottai A;Nasr SZ;Hassan F;Irani S;O'Brien LM;Chervin RD
囊性纤维化（CF）是一种缩短寿命的遗传性疾病，影响约30，000名美国人。尽管患者经常报告打鼾、张口呼吸和失眠，但睡眠呼吸障碍（SDB）在多大程度上可能是这些投诉的基础仍然未知。对年龄、性别、种族和体重指数（BMI）个体匹配（1：2）的有和无CF的转诊患者的多导睡眠图结果进行单中心回顾性审查。29例儿童CF和23例成人CF的平均年龄分别为8.0±5.2岁（标准差）和35.9±12.9岁。CF组和非CF组在年龄和BMI方面匹配良好。与无CF的受试者相比，有CF的受试者发生中重度SDB的几率高3倍（儿童呼吸暂停低通气指数（AHI）≥ 5，成人≥ 15）（p=0.01）。CF组的夜间血氧饱和度最低值（最低SpO 2）低于非CF组（p=0.002）。对于AHI每增加1个单位，有CF的受试者与无CF的受试者相比，最小SpO 2下降幅度更大（p=0.05）。在CF受试者中，1秒用力呼气容积百分比预测值（FEV 1 PPD）与最低SpO 2相关（Pearson r=0.68，p<0.0001），但与AHI无关（r=-0.19，p=0.27）。对于AHI每增加1个单位，FEV 1 PPD较低的患者的最小SpO 2下降幅度大于正常患者（p=0.01）。有CF的转诊患者与无CF的转诊患者相比，SDB的严重程度可能更差。SDB可能改变CF肺病与夜间低氧血症之间的关系。包括肺功能在内的肺部疾病严重程度的标志物不能预测SDB的严重程度，这表明需要常规的多导睡眠图来筛查这种睡眠障碍。尽管囊性纤维化（CF）患者反复主诉失眠、打鼾和口呼吸，但对睡眠呼吸障碍（SDB）的频率和严重程度知之甚少。SDB对健康的不利影响可能会引起CF患者的特别关注，因为他们已经面临着限制生命的疾病。与无CF的患者相比，有CF的患者可能有更严重的SDB。此外，SDB可能导致CF和非CF组之间的睡眠数量和质量的一些差异。CF肺病和夜间低氧血症之间的关系可能会因SDB的存在而改变。SDB检测可能有助于确定CF患者中显著发病率和死亡率的可改变风险因素。
Cystic fibrosis (CF) is a life-shortening, genetic disease that affects approximately 30,000 Americans. Although patients frequently report snoring, mouth breathing, and insomnia, the extent to which sleep-disordered breathing (SDB) may underlie these complaints remains unknown. Single-center retrospective review of polysomnography results from referred patients with and without CF individually-matched (1:2) for age, gender, race, and body mass index (BMI). Mean ages were 8.0±5.2(sd) and 35.9±12.9 years, among 29 children and 23 adults with CF respectively. The CF and non-CF groups were well-matched in age and BMI. Subjects with vs. without CF had 3 times greater odds of moderate-severe SDB (apnea-hypopnea index (AHI) ≥ 5 in children, ≥ 15 in adults) (p=0.01). Nocturnal oxygen saturation nadir (Minimum SpO2) was lower among CF vs. non-CF groups (p=0.002). For every 1-unit increase in AHI, the decline in Minimum SpO2 was larger for subjects with vs. without CF (p=0.05). In subjects with CF, forced expiratory volume in 1 second percent predicted (FEV1 PPD) was associated with Minimum SpO2 (Pearson r=0.68, p<0.0001) but not AHI (r=−0.19, p=0.27). For every 1-unit increase in AHI, magnitude of decline in Minimum SpO2 was larger for those with low vs. normal FEV1 PPD (p=0.01). Severity of SDB may be worse among referred patients with vs. without CF. The SDB may modify the relationship between CF lung disease and nocturnal hypoxemia. Markers of lung disease severity including lung function do not predict SDB severity, suggesting the need for routine polysomnography to screen for this sleep disorder. Little is known about the frequency or severity of sleep-disordered breathing (SDB) in patients with cystic fibrosis (CF) despite recurrent complaints of insomnia, snoring, and mouth breathing. The adverse health impact of SDB could create particular concern for individuals with CF, who already confront a life-limiting illness. Patients with vs. without CF may have more severe SDB. Furthermore, SDB could contribute to some of the differences in sleep quantity and quality between CF and non-CF groups. The relationship between CF lung disease and nocturnal hypoxemia may be modified by the presence of SDB. Testing for SDB may help identify a modifiable risk factor for significant morbidity and mortality among patients with CF.
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影响因子：
5
作者：
Cleveland, RH;Neish, AS;Colin, AA
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DOI：
10.1016/j.bbi.2016.12.026
发表时间：
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期刊：
Brain, behavior, and immunity
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通讯作者：
Bixler EO
DOI：
10.1164/rccm.201510-2099oc
发表时间：
2016-09-15
影响因子：
24.7
作者：
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