Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Sleep-disordered breathing in patients with cystic fibrosis

Distúrbios respiratórios do sono em pacientes com fibrose cística

Jefferson Veronezi1,2, Ana Paula Carvalho3, Claudio Ricachinewsky4, Anneliese Hoffmann4, Danielle Yuka Kobayashi5, Otavio Bejzman Piltcher6, Fernando Antonio Abreu e Silva7, Denis Martinez1,2,8

J Bras Pneumol.2015;41(4):351-357

Abstract PDF PT PDF EN Portuguese Text

Objective: To test the hypothesis that disease severity in patients with cystic fibrosis (CF) is correlated with an increased risk of sleep apnea. Methods: A total of 34 CF patients underwent clinical and functional evaluation, as well as portable polysomnography, spirometry, and determination of IL-1β levels. Results: Mean apnea-hypopnea index (AHI), SpO2 on room air, and Epworth Sleepiness Scale score were 4.8 ± 2.6, 95.9 ± 1.9%, and 7.6 ± 3.8 points, respectively. Of the 34 patients, 19 were well-nourished, 6 were at nutritional risk, and 9 were malnourished. In the multivariate model to predict the AHI, the following variables remained significant: nutritional status (β = −0.386; p = 0.014); SpO2 (β = −0.453; p = 0.005), and the Epworth Sleepiness Scale score (β = 0.429; p = 0.006). The model explained 51% of the variation in the AHI. Conclusions: The major determinants of sleep apnea were nutritional status, SpO2, and daytime sleepiness. This knowledge not only provides an opportunity to define the clinical risk of having sleep apnea but also creates an avenue for the treatment and prevention of the disease.

 


Keywords: Cystic fibrosis; Oxygenation; Sleep apnea, obstructive.

 


Effects of exercise on sleep symptoms in patients with severe obstructive sleep apnea

Efeitos do exercício nos sintomas do sono em pacientes com apneia obstrutiva do sono

Roberto Pacheco da Silva1,a, Denis Martinez1,2,3,b, Kelly Silveira da Silva Bueno1,c, Jhoana Mercedes Uribe-Ramos2,d

J Bras Pneumol.2019;45(3):e20180085-e20180085

Abstract PDF PT PDF EN Portuguese Text Appendix

Objective: To investigate the extent to which exercise is associated with symptoms in patients with severe obstructive sleep apnea (OSA). Methods: We included subjects with an apnea-hypopnea index (AHI) > 30 events/h who completed validated sleep and exercise questionnaires. We compared symptom frequency/scores between exercisers and nonexercisers, adjusting for the usual confounders. Results: The sample included 907 nonexercisers and 488 exercisers (mean age, 49 ± 14 years; mean AHI, 53 ± 20 events/h; 81% men). Nonexercisers and exercisers differed significantly in terms of obesity (72% vs. 54%), the mean proportion of sleep in non-rapid eye movement stage 3 sleep (9 ± 8% vs. 11 ± 6%), and tiredness (78% vs. 68%). Nonexercisers had a higher symptom frequency/scores and poorer sleep quality. Adjustment for exercise weakened the associations between individual symptoms and the AHI, indicating that exercise has a mitigating effect. In binary logistic models, exercise was associated with approximately 30% lower adjusted questionnaire1 score > 2, tiredness; poor-quality sleep, unrefreshing sleep, and negative mood on awakening. Although the odds of an Epworth Sleepiness Scale score > 10 were lower in exercisers, that association did not withstand adjustment for confounders. Conclusions: Exercise is associated with lower frequency/intensity of symptoms in patients with severe OSA. Because up to one third of patients with severe OSA might exercise regularly and therefore be mildly symptomatic, it is important not to rule out a diagnosis of OSA in such patients.

 


Keywords: Sleep apnea syndromes; Exercise; Sleepiness; Polysomnography.

 


 

 


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