Chest
Ventilation And Oxygenation Changes During Sleep In Cystic Fibrosis
Section snippets
METHODS
Six adolescent males, ages 10 to 16, with the diagnosis of CF confirmed by an elevated pilocarpine iontophoretic sweat chloride, were studied both awake and asleep. Informed consent of patients and parents was obtained in all cases. The patients’ anthropometric data are presented in Table 1. The mean height was 155 cm (range of 137 to 175 cm); and the mean weight was 37.9 kg (range of 30.0 to 47.7 kg). Only one of six patients was <5 percent predicted for height, while five of six patients were
Awake
The awake pulmonary function tests, oxygen saturation, and acid base status are shown in Table 1. The patients represent a heterogeneous group with respect to all the parameters. All patients demonstrated airways obstruction of a moderate to severe degree, with a mean FEV1/FVC = 0.52 ±.05 (range: 0.41 to 0.72), and a variable degree of air trapping (RV/TLC) with a reduced mean FVC of 61 percent predicted (range: 43 percent to 99 percent). All patients demonstrated oxygen desaturation at rest
DISCUSSION
This study examined the contributions of alveolar hypoventilation and ventilatory pattern to sleep-induced arterial hypoxemia in patients with CF. Although these patients varied substantially, the general trend during NREM and REM sleep showed a reduced minute ventilation and tidal volume along with a more variable breathing pattern during REM as compared to either NREM or wakefulness. The contribution of alveolar hypoventilation and CO2 retention to oxygen desaturation was most evident during
ACKNOWLEDGMENTS
The authors would like to acknowledge the support of the Medical Research Service of the Veterans Administration as well as the Graduate and Medical Schools of the University of Wisconsin. In addition, we would like to thank Drs. Phillip Farrell and Elaine Mischler for their cooperation in obtaining patients for this study, and also Gary Thomas and Elfie Garber for their technical assistance.
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Cited by (73)
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 :Individuals with CF often experience a significant decline in their oxygen saturation during sleep from what is believed to be a sleep-related reduction in lung volumes and ventilation [46,47]. This desaturation is worse during REM sleep as compared to non-REM (NREM) or slow-wave sleep [37,46–49]. Clinically significant nocturnal hypoxemia has been observed in children with moderate-severe CF lung disease [38,46,50].
Cystic Fibrosis
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionCystic fibrosis and sleep
2014, Clinics in Chest MedicineSleep in Infants and Children with Chronic Respiratory Disorders
2013, Encyclopedia of SleepSleep in Infants and Children with Chronic Respiratory Disorders
2013, Encyclopedia of Sleep
Manuscript received November 29; revision accepted February 22.
From the Department of Pediatrics, University of Arizona, Arizona Health Sciences Center, Tucson; and the Department of Medicine, William Middleton Memorial VA Hospital, and Department of Preventive Medicine, University of Wisconsin, Madison.
This investigation was supported in part by grants NHLI 15469 and NHLI Research Career Development Award IK04HL00149.