Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2001 Jan;84(1):50–54. doi: 10.1136/adc.84.1.50

Nocturnal oximetry in infants with cystic fibrosis

M Villa 1, J Pagani 1, V Lucidi 1, S Palamides 1, R Ronchetti 1
PMCID: PMC1718605  PMID: 11124784

Abstract

AIM—To investigate whether children with cystic fibrosis under 3 years of age have disordered breathing and episodes of oxygen desaturation during sleep.
METHODS—We studied 19 infants (9 boys and 10 girls) with cystic fibrosis, mean age 13.1 months (range 3-36 months) and 20 age and sex matched healthy subjects. Patients and controls underwent an overnight polysomnographic study and respiratory function testing on the following morning.
RESULTS—Seven patients with ongoing respiratory tract inflammation had disordered breathing and episodes of oxygen desaturation during sleep. Pulse oximetry showed a significantly lower mean oxygen saturation (SaO2) and a higher percentage of total sleep time spent with SaO2 less than 93% in symptomatic children than in controls.
CONCLUSION—Results suggest that infants and young children with cystic fibrosis and mild airways inflammation (rhinitis, cough, red throat) have episodes of oxygen desaturation during sleep.



Full Text

The Full Text of this article is available as a PDF (108.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen M. B., Mellon A. F., Simmonds E. J., Page R. L., Littlewood J. M. Changes in nocturnal oximetry after treatment of exacerbations in cystic fibrosis. Arch Dis Child. 1993 Aug;69(2):197–201. doi: 10.1136/adc.69.2.197. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ballard R. D., Sutarik J. M., Clover C. W., Suh B. Y. Effects of non-REM sleep on ventilation and respiratory mechanics in adults with cystic fibrosis. Am J Respir Crit Care Med. 1996 Jan;153(1):266–271. doi: 10.1164/ajrccm.153.1.8542127. [DOI] [PubMed] [Google Scholar]
  3. Beardsmore C. S., Bar-Yishay E., Maayan C., Yahav Y., Katznelson D., Godfrey S. Lung function in infants with cystic fibrosis. Thorax. 1988 Jul;43(7):545–551. doi: 10.1136/thx.43.7.545. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Beardsmore C. S., MacFadyen U. M., Moosavi S. S., Wimpress S. P., Thompson J., Simpson H. Measurement of lung volumes during active and quiet sleep in infants. Pediatr Pulmonol. 1989;7(2):71–77. doi: 10.1002/ppul.1950070204. [DOI] [PubMed] [Google Scholar]
  5. Block A. J., Boysen P. G., Wynne J. W. The origins of cor pulmonale; a hypothesis. Chest. 1979 Feb;75(2):109–110. doi: 10.1378/chest.75.2.109. [DOI] [PubMed] [Google Scholar]
  6. Boysen P. G., Block A. J., Wynne J. W., Hunt L. A., Flick M. R. Nocturnal pulmonary hypertension in patients with chronic obstructive pulmonary disease. Chest. 1979 Nov;76(5):536–542. doi: 10.1378/chest.76.5.536. [DOI] [PubMed] [Google Scholar]
  7. Calverley P. M., Brezinova V., Douglas N. J., Catterall J. R., Flenley D. C. The effect of oxygenation on sleep quality in chronic bronchitis and emphysema. Am Rev Respir Dis. 1982 Aug;126(2):206–210. doi: 10.1164/arrd.1982.126.2.206. [DOI] [PubMed] [Google Scholar]
  8. Cassio A., Bernardi F., Piazzi S., Capelli M., Frejaville E., Villa M. P., Martelli E., Balsamo A., Salardi S., Merighi R. Neonatal screening for cystic fibrosis by dried blood spot trypsin assay. Results in 47 127 newborn infants from a homogeneous population. Acta Paediatr Scand. 1984 Jul;73(4):554–558. doi: 10.1111/j.1651-2227.1984.tb09970.x. [DOI] [PubMed] [Google Scholar]
  9. Coates A. L., Boyce P., Shaw D. G., Godfrey S., Mearns M. Relationship between the chest radiograph, regional lung function studies, exercise tolerance, and clinical condition in cystic fibrosis. Arch Dis Child. 1981 Feb;56(2):106–111. doi: 10.1136/adc.56.2.106. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Dankert-Roelse J. E., te Meerman G. J. Long term prognosis of patients with cystic fibrosis in relation to early detection by neonatal screening and treatment in a cystic fibrosis centre. Thorax. 1995 Jul;50(7):712–718. doi: 10.1136/thx.50.7.712. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Douglas N. J., Calverley P. M., Leggett R. J., Brash H. M., Flenley D. C., Brezinova V. Transient hypoxaemia during sleep in chronic bronchitis and emphysema. Lancet. 1979 Jan 6;1(8106):1–4. doi: 10.1016/s0140-6736(79)90451-3. [DOI] [PubMed] [Google Scholar]
  12. Eigen H., Rosenstein B. J., FitzSimmons S., Schidlow D. V. A multicenter study of alternate-day prednisone therapy in patients with cystic fibrosis. Cystic Fibrosis Foundation Prednisone Trial Group. J Pediatr. 1995 Apr;126(4):515–523. doi: 10.1016/s0022-3476(95)70343-8. [DOI] [PubMed] [Google Scholar]
  13. Fleetham J., West P., Mezon B., Conway W., Roth T., Kryger M. Sleep, arousals, and oxygen desaturation in chronic obstructive pulmonary disease. The effect of oxygen therapy. Am Rev Respir Dis. 1982 Sep;126(3):429–433. doi: 10.1164/arrd.1982.126.3.429. [DOI] [PubMed] [Google Scholar]
  14. Francis P. W., Muller N. L., Gurwitz D., Milligan D. W., Levison H., Bryan A. C. Hemoglobin desaturation: its occurrence during sleep in patients with cystic fibrosis. Am J Dis Child. 1980 Aug;134(8):734–740. doi: 10.1001/archpedi.1980.02130200004002. [DOI] [PubMed] [Google Scholar]
  15. Gaultier C., Praud J. P., Canet E., Delaperche M. F., D'Allest A. M. Paradoxical inward rib cage motion during rapid eye movement sleep in infants and young children. J Dev Physiol. 1987 Oct;9(5):391–397. [PubMed] [Google Scholar]
  16. Guilleminault C., Cummiskey J., Motta J. Chronic obstructive airflow disease and sleep studies. Am Rev Respir Dis. 1980 Sep;122(3):397–406. doi: 10.1164/arrd.1980.122.3.397. [DOI] [PubMed] [Google Scholar]
  17. Henderson-Smart D. J., Read D. J. Reduced lung volume during behavioral active sleep in the newborn. J Appl Physiol Respir Environ Exerc Physiol. 1979 Jun;46(6):1081–1085. doi: 10.1152/jappl.1979.46.6.1081. [DOI] [PubMed] [Google Scholar]
  18. Hudgel D. W., Devadatta P. Decrease in functional residual capacity during sleep in normal humans. J Appl Physiol Respir Environ Exerc Physiol. 1984 Nov;57(5):1319–1322. doi: 10.1152/jappl.1984.57.5.1319. [DOI] [PubMed] [Google Scholar]
  19. Kearley R., Wynne J. W., Block A. J., Boysen P. G., Lindsey S., Martin C. The effect of low flow oxygen on sleep-disordered breathing and oxygen desaturation. A study of patients with chronic obstructive lung disease. Chest. 1980 Nov;78(5):682–685. doi: 10.1378/chest.78.5.682. [DOI] [PubMed] [Google Scholar]
  20. Khan T. Z., Wagener J. S., Bost T., Martinez J., Accurso F. J., Riches D. W. Early pulmonary inflammation in infants with cystic fibrosis. Am J Respir Crit Care Med. 1995 Apr;151(4):1075–1082. doi: 10.1164/ajrccm/151.4.1075. [DOI] [PubMed] [Google Scholar]
  21. Mansell A. L. Sleep hypoxemia in patients with cystic fibrosis. Am J Dis Child. 1980 Aug;134(8):733–733. doi: 10.1001/archpedi.1980.02130200003001. [DOI] [PubMed] [Google Scholar]
  22. Moriette G., Chaussain M., Radvanyi-Bouvet M. F., Walti H., Pajot N., Relier J. P. Functional residual capacity and sleep states in the premature newborn. Biol Neonate. 1983;43(3-4):125–133. doi: 10.1159/000241619. [DOI] [PubMed] [Google Scholar]
  23. Muller N. L., Francis P. W., Gurwitz D., Levison H., Bryan A. C. Mechanism of hemoglobin desaturation during rapid-eye-movement sleep in normal subjects and in patients with cystic fibrosis. Am Rev Respir Dis. 1980 Mar;121(3):463–469. doi: 10.1164/arrd.1980.121.3.463. [DOI] [PubMed] [Google Scholar]
  24. Pond M. N., Conway S. P. Nocturnal oxygen desaturation and spirometric parameters in adults with cystic fibrosis. Thorax. 1995 May;50(5):539–542. doi: 10.1136/thx.50.5.539. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Ramsey B. W., Gore E. J., Smith A. L., Cooney M. K., Redding G. J., Foy H. The effect of respiratory viral infections on patients with cystic fibrosis. Am J Dis Child. 1989 Jun;143(6):662–668. doi: 10.1001/archpedi.1989.02150180040017. [DOI] [PubMed] [Google Scholar]
  26. Regnis J. A., Piper A. J., Henke K. G., Parker S., Bye P. T., Sullivan C. E. Benefits of nocturnal nasal CPAP in patients with cystic fibrosis. Chest. 1994 Dec;106(6):1717–1724. doi: 10.1378/chest.106.6.1717. [DOI] [PubMed] [Google Scholar]
  27. Spier S., Rivlin J., Hughes D., Levison H. The effect of oxygen on sleep, blood gases, and ventilation in cystic fibrosis. Am Rev Respir Dis. 1984 May;129(5):712–718. doi: 10.1164/arrd.1984.129.5.712. [DOI] [PubMed] [Google Scholar]
  28. Stokes D. C., McBride J. T., Wall M. A., Erba G., Strieder D. J. Sleep hypoxemia in young adults with cystic fibrosis. Am J Dis Child. 1980 Aug;134(8):741–743. doi: 10.1001/archpedi.1980.02130200011004. [DOI] [PubMed] [Google Scholar]
  29. Tepper R. S., Eigen H., Stevens J., Angelicchio C., Kisling J., Ambrosius W., Heilman D. Lower respiratory illness in infants and young children with cystic fibrosis: evaluation of treatment with intravenous hydrocortisone. Pediatr Pulmonol. 1997 Jul;24(1):48–51. doi: 10.1002/(sici)1099-0496(199707)24:1<48::aid-ppul8>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  30. Tepper R. S., Hiatt P., Eigen H., Scott P., Grosfeld J., Cohen M. Infants with cystic fibrosis: pulmonary function at diagnosis. Pediatr Pulmonol. 1988;5(1):15–18. doi: 10.1002/ppul.1950050105. [DOI] [PubMed] [Google Scholar]
  31. Tepper R. S., Skatrud J. B., Dempsey J. A. Ventilation and oxygenation changes during sleep in cystic fibrosis. Chest. 1983 Oct;84(4):388–393. doi: 10.1378/chest.84.4.388. [DOI] [PubMed] [Google Scholar]
  32. Unger M., Atkins M., Briscoe W. A., King T. K. Potentiation of pulmonary vasoconstrictor response with repeated intermittent hypoxia. J Appl Physiol Respir Environ Exerc Physiol. 1977 Oct;43(4):662–667. doi: 10.1152/jappl.1977.43.4.662. [DOI] [PubMed] [Google Scholar]
  33. Walti H., Moriette G., Radvanyi-Bouvet M. F., Chaussain M., Morel-Kahn F., Pajot N., Relier J. P. Influence of breathing pattern on functional residual capacity in sleeping newborn infants. J Dev Physiol. 1986 Jun;8(3):167–172. [PubMed] [Google Scholar]
  34. Wynne J. W., Block A. J., Hemenway J., Hunt L. A., Flick M. R. Disordered breathing and oxygen desaturation during sleep in patients with chronic obstructive lung disease (COLD). Am J Med. 1979 Apr;66(4):573–579. doi: 10.1016/0002-9343(79)91166-5. [DOI] [PubMed] [Google Scholar]
  35. van Haren E. H., Lammers J. W., Festen J., Heijerman H. G., Groot C. A., van Herwaarden C. L. The effects of the inhaled corticosteroid budesonide on lung function and bronchial hyperresponsiveness in adult patients with cystic fibrosis. Respir Med. 1995 Mar;89(3):209–214. doi: 10.1016/0954-6111(95)90249-x. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES