An Integrated Approach Toward the Clinical and Polysomnographic Characteristics of OSA Accompanying IPF.

Abstract

Coincidance of idiopathic pulmonary fibrosis (IPF) and the obstructive sleep apnea syndrome (OSA) may have important effects on the pathogenesis of each other. Our aim is to define clinical characteristics of patients with IPF and OSA and to identify a combined index to determine the severity of both diseases together. The clinical and polysomnographic characteristics of 22 patients with OSA and IPF who underwent nocturnal polysomnography (NPSG) were retrospectively evaluated and compared with 23 OSA patients without any other pulmonary comorbidities. We demonstrated high frequency of OSA within our study group (94,7%) all of whom had at least one of the majör symptoms of OSA. Lower AHI, lower neck circumference, higher percentage of deep sleep (nREM3) and less comorbidities were observed in the study group when compared to OSA with no other pulmonary comorbidities (p<0,05). When restaged into a compound index according to the gender, age and physiology (GAP) index, the patients with mild IPF and OSA showed the same life and sleep quality with the patients who have higher GAP index. All patients with IPF must be questioned for the major symptoms of sleep related breathing disorders (SRBD). Clinical suspicion for OSA must prompt NPSG. With the presence of moderate-severe OSA, the life and sleep quality of patients with mild IPF can be at the same level of patients with severe IPF.