Abstract
The relationship between sleep disorders and bronchiectasis has not been well described. We hypothesize that, due to the irreversible dilatation of the bronchi, the presence of secretions, and airflow obstruction, patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousal. A cross-sectional observational study was performed involving 49 patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis (NCFB). All patients underwent clinical evaluation, spirometry, and polysomnography, and were evaluated for the presence of excessive daytime sleepiness (EDS) and risk of obstructive sleep apnea (OSA). The mean age of the participants was 50.3 ± 13.6 years; 51.1% of patients were male and had a mean body mass index of 23.8 ± 3.4 kg/m2. The mean total sleep time (TST) was 325.15 ± 64.22 min with a slight reduction in sleep efficiency (84.01 ± 29.2%). Regarding sleep stages, stage 1 sleep and REM sleep were abnormal. OSA was present in 40.82% of the patients. The mean arousal index was 5.6 ± 2.9/h and snoring was observed in 71.43% of the patients. The oxygen desaturation index (ODI) was 14.35 ± 15.36/h, mean minimum oxygen saturation (SpO2 nadir) was 83.29 ± 7.99%, and mean TST with an SpO2 less than 90% was 30.21 ± 60.48 min. EDS was exhibited by 53.06% of the patients and 55.1% were at high risk of developing OSA. The patients infected by Pseudomonas aeruginosa had higher apnea-hypopnea indices, ODI, and TST with SpO2 < 90%, and lower values of SpO2 nadir. Adult patients with clinically stable NCFB, especially those infected by Pseudomonas aeruginosa, display EDS and a high prevalence of OSA, associated with considerable oxygen desaturation during sleep.
Highlights
Bronchiectasis (BCTS) is a chronic disease characterized by irreversible, permanent, and abnormal dilatation of the bronchi and bronchioles [1,2,3,4,5]
It is estimated that there are in the United States of America at least 110,000 adult patients diagnosed with BCTS: 4.2 per 100,000 people between 18 and 34 years of age, and 272 per 100,000 people aged 75 years or older [11]
Due to the irreversible dilatation of the bronchi, the presence of sputum, and airflow obstruction, patients with non-cystic fibrosis bronchiectasis (NCFB) may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousal
Summary
Bronchiectasis (BCTS) is a chronic disease characterized by irreversible, permanent, and abnormal dilatation of the bronchi and bronchioles [1,2,3,4,5]. An epidemiological study from Finland suggests an incidence of 2.7 per 100,000 people [12], while in New Zealand, an overall incidence of 3.7 per 100,000 children was noted [13]. Certain demographic groups, such as those with little access to health, lower socio-economic status, and high rates of lung infection in childhood, are at high risk for BCTS [14,15]. In a study of 42,500 admissions to a Brazilian hospital specializing in lung diseases, 0.4% of patients (170) hospitalized between 1978 and 2001 were diagnosed with BCTS [16]. Another recent study conducted in Germany found an average annual rate of hospital admissions of patients with BCTS of 9.4 per 100,000 [17]
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