Abstract

PurposeSleep disturbances and poor sleep quality are known to be present in patients with CF. Regular physical activity plays an important role in the treatment of CF patients due to its positive influence on progression of disease and quality of life. The aim of this work is to create a home-based sleep and activity profile and to investigate the influence of habitual physical activity (HPA) on sleep quality in children, adolescents, and adults with CF.MethodsA total of 109 CF patients (64 male, mean age 22.7 ± 12.0 years; mean ppFEV1 63.0 ± 26.7) were equipped with an actigraph for a home-based collection of data on sleep and activity over 4 weeks.ResultsAge, FEV1, and BMI affect sleep and activity in CF patients. Especially younger age and higher FEV1 show a great influence on certain aspects of sleep (SE, TST, TIB, WASO, # of awakenings) and activity and its different intensities. General HPA does not affect sleep, but there is a strong correlation between times spent in vigorous to very vigorous intensities and better sleep quality.ConclusionBesides younger age and higher FEV1, daily activity in higher intensities influences sleeping behavior of CF patients in a positive way. Patients with poor sleep quality and sleep disturbances possibly benefit from an intensification of physical activity in the home environment.Trail registrationnumber: 14–6117-BO (University Duisburg-Essen) and NCT 03518697 (clinical trials).

Highlights

  • Cystic fibrosis (CF) is an autosomal-recessive disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene

  • Sleep disturbances and poor sleep quality are common in children, adolescents, and adults with CF, especially in those with advanced lung disease [2, 3]

  • We analyzed long-term actigraphy-measured sleep and activity data of overall 109 children, adolescents, and adults with CF in a home-based setting. The aim of this analysis was (1) to create a sleep and activity profile and (2) to investigate the relationship between physical activity and sleep quality regarding disease severity and age in a large CF cohort. This is a sub-analysis of the CFmobil project, a 12-month partially supervised exercise program for CF patients ≥ 6 years of age, which was conducted from April 2014 to August 2018 at three regional CF centers (University Children’s Hospital Essen, University Children’s Hospital Bochum, and the Adult Cystic Fibrosis Center at the Ruhrlandklinik Essen) in Germany

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Summary

Introduction

Cystic fibrosis (CF) is an autosomal-recessive disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. Sleep disturbances and poor sleep quality are common in children, adolescents, and adults with CF, especially in those with advanced lung disease [2, 3]. Coughing, snoring, PEGfeeding, CF-related diabetes, and nocturnal oxygen desaturation can clearly influence the sleeping behavior of CF patients [4]. Participation in regular physical activity plays a crucial role in CF treatment. Regardless of lung function and age, has a positive effect on the course of the disease [5]. Active patients are characterized by a decreased mortality [6], slower decline in lung function (FEV1) [7], better health-related quality of life (HRQOL) [8], and a better sleep quality [9]

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