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Sleep architecture in children and adolescents with cystic fibrosis and the association with severity of lung disease

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Abstract

Previous studies have shown that sleep complaints are common in adult patients with cystic fibrosis (CF). However, there is very little data on sleep in children and adolescents with CF and the association with severity of lung disease. A prospective study was conducted in CF children and age-matched controls. All patients completed sleep questionnaire and underwent an overnight polysomnographic study. Thirty-eight children and adolescents met the criteria for entry into the analysis, 24 children and adolescents with CF (S) and 14 controls (C). Sleep complaints were common in children and adolescents with CF; 43.5% reported sleep onset problem, 39.1% reported sleep maintenance problem, 30.4% were noted to snore at night, and 73.9% reported daytime sleepiness. Children and adolescents with CF had a significant decrease in sleep efficiency [SE; 75.2 ± 2.5% (S) vs 85.6 ± 1.7%(C); P < 0.01], prolonged rapid eye movement (REM) latency [150.5 ± 16.6 min (S) vs 85.6 ± 11.0 min (C); P < 0.05], and reduction in percentage of REM sleep [12.7 ± 1.5% (S) vs 18.3 ± 1.3% (C); P < 0.05]. The degree of sleep disruption as indicated by SE was correlated with forced expiratory volume in one second (FEV1; r = 0.52, P < 0.05). However, there was no significant correlation between SE and minimum oxygen saturation [r = 0.30, P=not significant (NS)] or SE and maximal end-tidal pCO2 (r = 0.11, P=NS). It is concluded that children and adolescents with CF have frequent sleep complaints and significant alteration in the sleep architecture. The magnitude of sleep disruption is associated with severity of lung disease, but is not directly correlated with the degree of nocturnal hypoxemia or hypoventilation. It is speculated that sleep disruption in children and adolescents with CF may have an impact on quality of life and clinical outcomes in this population.

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Acknowledgment

This study was supported by the American Lung Association (number RG-183-N), the Constance Kaufman Fund, and the General Clinical Research Center (5M01RR005096) at Tulane University Health Science Center. Part of the study was presented as an abstract at the 2003 North American Cystic Fibrosis Conference and the International Conference of the American Thoracic Society 2004. Dr. Kamal Naqvi is currently an Assistant Professor of Pediatrics at the University of Texas Southwestern Medical School and Children’s Hospital of Dallas, Texas. Dr. Narong Simakajornboon is currently at the Cincinnati Children’s Hospital Medical Center.

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Authors and Affiliations

  1. Constance S. Kaufman Pediatric Pulmonary Research Laboratory, Section of Pediatric Pulmonology, Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA

    S. Kamal Naqvi & Narong Simakajornboon

  2. Comprehensive Sleep Medicine Center, Tulane University Hospital and Clinics, New Orleans, LA, USA

    S. Kamal Naqvi, Carlos Sotelo, Lisa Murry & Narong Simakajornboon

  3. Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 2021, Cincinnati, OH, 45229, USA

    Narong Simakajornboon

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  1. S. Kamal Naqvi
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  2. Carlos Sotelo
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  3. Lisa Murry
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  4. Narong Simakajornboon
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Correspondence to Narong Simakajornboon.

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Naqvi, S.K., Sotelo, C., Murry, L. et al. Sleep architecture in children and adolescents with cystic fibrosis and the association with severity of lung disease. Sleep Breath 12, 77–83 (2008). https://doi.org/10.1007/s11325-007-0123-0

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