Table 1 –
Polysomnography studies in children with CF.
| Reference | Sample size | Age (years) | Pulmonary Functions | Main findings | |||
|---|---|---|---|---|---|---|---|
| Cases | Controls | Cases | Controls | FEV1% | FVC% | ||
| Tepper 198322 | 6 | n/a | 10-16 | n/a | - | 61 (9) | Decreased minute ventilation and tidal volume, and hypoxia during sleep, more pronounced during REM sleep |
| Avital 199124 | 12 | n/a | 7-17 | n/a | 62 (9) | - | Theophylline reduced HR, improved SpO2, and disrupted sleep with lower SE and higher nocturnal wake time. No effect on AHI or PLM |
| Villa 200125 | 19 | 20 | 13.1mos (3-36) | Matched | - | - | Lower mean SpO2 (95.6% vs 96.9%) and SpO2 nadir (85.9% vs 89.1%); no differences in %REM (27% vs 28%). Differences more significant in children with symptoms of airway inflammation. |
| Naqvi 200826 | 24 | 14 | 14.2 (3.8)* | 10.7 (4.4) | - | - | Lower SpO2 nadir (90.3% vs 95.6%); lower SE (75.2% vs. 86.2%) and %REM (12.7% vs 18.3%) |
| Ramos 200927 | 63 | n/a | 2-14 | n/a | - | - | OSA (oAHI≥1) in 55.6% with signs of chronic rhinosinusitis |
| Suratwala 201128 | 25 | 25 | 8-20 | 7-20 | 99 (12) | 92 (14) | Lower mean SpO2 (96.6% vs 97.5%) and SpO2 nadir (92.5% vs 93.8%); no differences in SE (78% vs. 83%) or %REM (19% vs 18%). Nocturnal hypoxemia correlated with impaired glucose tolerance. |
| Spicuzza 201229 | 40 | 18 | 0.5-11 | Matched | 78.6 (4.7) | 81.7 (3.9) | Lower mean SpO2 (94.7% vs 97%); lower SE (80.4% vs. 87.8%) and %REM (11.7% vs 13.1%); higher AHI (7.3/hour vs 0.5/hour) |
| Ramos 201330 | 67 | n/a | 2-14 | n/a | 78.5 (67.0-92.8)† | - | Nocturnal hypoxemia correlated negatively with FEV1, FVC, arousal index and AHI. |
| Paranjape 201531 | 10 | 10 | 9.6 (3.6)† | 9.6 (3.6) | 87.0 (25.7) | - | Children with CF vs snoring age- and BMI-matched controls. Lower mean SpO2 in both REM & NREM, and SpO2 nadir (90% vs 93%); no differences in %REM (19.9% vs 17.5%) or SE (81.6% vs. 81.7%). No difference in SDB parameters on PSG. |
| Silva 201632 | 33 | n/a | 6-18 | n/a | Z score −1.76 (1.6) | - | 87.9% had reported sleep-related complaints. SE, WASO and sleep latency were impaired. REM% was within normal limits. FEV1 was negatively associated with mean nocturnal SpO2. |
| Waters 201633 | 46 | n/a | 8-12 | n/a | 74.6 (18.8) | 87.4 (16.5) | Respiratory parameters altered included increased respiratory rate in slow-wave sleep and mild CO2 retention in REM, both of which were independently associated with FEV1. |
| Isaiah 2019 35 | 35 | n/a | 11.6 (9.5-13.1)** | n/a | 60.7 (53.0-68.5) | - | OSA present in 50%; FEV1 <53% was the best predictor for sleep hypoxemia. |
| Barbosa 202034 | 31 | n/a | 9.6 (7.9–15.1) † | n/a | 68.1 (24.4) | 77.8 (21.4) | OSA present in 32.3%; nocturnal hypoxemia in 29%; OSA and hypoxemia associated with lower FVC and FEV1. |
*
mean (SE).
†
median (SD).
**
mean (95% confidence interval). n/a: not applicable.
Abbreviations: CF: cystic fibrosis; MV: minute ventilation; Vt: tidal volume; REM: rapid eye movement; HR: heart rate; SpO2: oxygen saturation; SE: sleep efficiency as percent of total sleep time; AHI: apnea hypopnea index; PLM: periodic leg movements; %REM: REM as percent of TST; OSA: obstructive sleep apnea; NREM: non REM; FEV1: forced expiratory volume at 1 sec; FVC: Forced Vital Capacity