TY - JOUR
T1 - Risk factors for obstructive sleep apnea in cystic fibrosis
AU - Shakkottai, Aarti
AU - Irani, Sanaya
AU - Nasr, Samya Z.
AU - O'Brien, Louise M.
AU - Chervin, Ronald D.
N1 - Funding Information:
The authors are grateful to Judy Fetterolf, RPSGT, REEGT and Casey Cox, RPSGT, REEGT for their assistance with data extraction. This study was performed at the Michigan Medicine Sleep Disorders Center at the University of Michigan. Dr. Aarti Shakkottai was supported by NIH training grants (F32HL145915, T32NS007222). Dr.?Ronald D. Chervin was supported in part by U01 NS099043, U01 HL125295, R01 HD082129, R01 HL147261, and R61 HL154095. None of the other authors had relevant financial support.
Funding Information:
The authors are grateful to Judy Fetterolf, RPSGT, REEGT and Casey Cox, RPSGT, REEGT for their assistance with data extraction. This study was performed at the Michigan Medicine Sleep Disorders Center at the University of Michigan. Dr. Aarti Shakkottai was supported by NIH training grants (F32HL145915, T32NS007222). Dr. Ronald D. Chervin was supported in part by U01 NS099043, U01 HL125295, R01 HD082129, R01 HL147261, and R61 HL154095. None of the other authors had relevant financial support.
Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2022/4
Y1 - 2022/4
N2 - Introduction: Despite emerging data that suggest a high frequency and severity of obstructive sleep apnea (OSA) among patients with cystic fibrosis (CF), few of them are referred for polysomnography. Little is known about which patients with CF are at increased risk for OSA and which sleep symptoms merit investigation. Methods: A single-center retrospective analysis of clinical and polysomnographic data from 2009, January 1 to October 31, 2020 in referred children and adults with CF. Results: Among 74 patients (42 children, 32 adults) with CF, 39 (53%) had OSA. No age or sex differences emerged in OSA frequency. Mean apnea–hypopnea index (AHI) was higher among overweight/obese adults (n = 16) as compared with adults of normal weight or underweight (11.4 vs. 6.2; p = 0.005). Adults with (n = 10) versus without a crowded oropharynx had 13.0 times greater odds of OSA (95% confidence interval (CI): 1.4, 121.4; p = 0.02). Children with (n = 24) versus without tonsillar hypertrophy had a higher risk for OSA (OR = 5.2; 95% CI: 1.4, 19.8; p = 0.02), as did children with (n = 10) versus without symptomatic chronic sinusitis (OR = 5.8; 95% CI: 1.1, 32.1; p = 0.04). Neither snoring, excessive daytime sleepiness, nor lung disease severity were associated with OSA. Conclusion: Key risk factors for OSA may differ between children and adults with CF: upper airway pathology appears important in children and overweight/obesity or a crowded oropharynx in adults. Given the lack of sensitivity of snoring, daytime sleepiness, and lung disease severity, detection of OSA may require a low threshold for polysomnographic assessment in this vulnerable population.
AB - Introduction: Despite emerging data that suggest a high frequency and severity of obstructive sleep apnea (OSA) among patients with cystic fibrosis (CF), few of them are referred for polysomnography. Little is known about which patients with CF are at increased risk for OSA and which sleep symptoms merit investigation. Methods: A single-center retrospective analysis of clinical and polysomnographic data from 2009, January 1 to October 31, 2020 in referred children and adults with CF. Results: Among 74 patients (42 children, 32 adults) with CF, 39 (53%) had OSA. No age or sex differences emerged in OSA frequency. Mean apnea–hypopnea index (AHI) was higher among overweight/obese adults (n = 16) as compared with adults of normal weight or underweight (11.4 vs. 6.2; p = 0.005). Adults with (n = 10) versus without a crowded oropharynx had 13.0 times greater odds of OSA (95% confidence interval (CI): 1.4, 121.4; p = 0.02). Children with (n = 24) versus without tonsillar hypertrophy had a higher risk for OSA (OR = 5.2; 95% CI: 1.4, 19.8; p = 0.02), as did children with (n = 10) versus without symptomatic chronic sinusitis (OR = 5.8; 95% CI: 1.1, 32.1; p = 0.04). Neither snoring, excessive daytime sleepiness, nor lung disease severity were associated with OSA. Conclusion: Key risk factors for OSA may differ between children and adults with CF: upper airway pathology appears important in children and overweight/obesity or a crowded oropharynx in adults. Given the lack of sensitivity of snoring, daytime sleepiness, and lung disease severity, detection of OSA may require a low threshold for polysomnographic assessment in this vulnerable population.
KW - cystic fibrosis (CF)
KW - sleep medicine
UR - http://www.scopus.com/inward/record.url?scp=85122765583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85122765583&partnerID=8YFLogxK
U2 - 10.1002/ppul.25811
DO - 10.1002/ppul.25811
M3 - Article
C2 - 34967157
AN - SCOPUS:85122765583
VL - 57
SP - 926
EP - 934
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
SN - 8755-6863
IS - 4
ER -