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Early Occurrence of Obstructive Sleep Apnea in Infants and Children With Cystic Fibrosis

Lucia Spicuzza, MD, PhD; Concetta Sciuto, MD; Salvatore Leonardi, MD; Mario La Rosa, MD
Arch Pediatr Adolesc Med. 2012;166(12):1165-1169. doi:10.1001/archpediatrics.2012.1177.
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Objectives  To assess the occurrence of sleep-disordered breathing, hypoxemia, and sleep architecture in a cohort of infants and children with cystic fibrosis (CF) and normal or mildly impaired lung function in stable clinical condition.

Design  Case-control study.

Setting  Cystic Fibrosis Unit of a university hospital and pediatric sleep laboratory.

Participants  A total of 40 children (aged 6 months to 11 years) with CF in stable condition and 18 healthy age-matched control subjects.

Intervention  Nocturnal sleep and cardiorespiratory monitoring was performed using a full polysomnographic recording in a sleep laboratory.

Main Outcomes Measures  Sleep architecture and respiratory variables.

Results  Although awake oxyhemoglobin saturation (SaO2) values were similar in the 2 groups (98%), the CF group had significantly lower values of nocturnal mean SaO2. The apnea-hypopnea index was significantly higher in the CF group compared with the controls (mean [SE], 7.3 [1.3] vs 0.5 [0.4], respectively, P < .001), particularly in preschool-aged children and in children with upper airway abnormalities. In addition, 28 (70%) of the 40 children with CF had mild to moderate obstructive sleep apnea (defined as an apnea-hypopnea index >2). Children with CF compared with controls also had reduced sleep efficiency (CF group vs controls mean [SE], 80% [41%] vs 88% [13.1%], P < .001), rapid eye movement sleep duration (11% [0.9%] vs 13% [1%], P < .05), and increased number of arousals per hour (11.0 [10] vs 8.2 [0.7], P < .001).

Conclusions  This study showed an early occurrence of obstructive sleep apnea in children with CF in stable condition, associated with a mild level of sleep disruption. Early routine nocturnal respiratory monitoring is advised in children with CF.

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Grahic Jump Location

Figure. Age-related distribution of apnea/hypopnea index (AHI) (A) and daytime (squares) and sleep (circles) mean (SE) oxyhemoglobin saturation (SaO2) (B) in children with cystic fibrosis and normal or mildly impaired lung function in stable clinical condition.

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