Sleep-related breathing disturbances in idiopathic pulmonary fibrosis

Abstract

<b>Background:</b> Sleep-related breathing disorders (SRBD) have received little attention in idiopathic pulmonary fibrosis (IPF). This study investigated the effect of SRBD on symptoms, sleep profile, hypoxic load, and cardiopulmonary performance in IPF. <b>Methods:</b> This cross-sectional diagnostic study investigated stable IPF patients without oxygen therapy via polysomnography, cardiopulmonary exercise test, body plethysmography and CO diffusion measurement. Symptoms were assessed using the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). <b>Results:</b> 22 of 45 IPF patients had SRBD. Anthropometric data and lung function were highly comparable between patients with and without SRBD, as were ESS and PSQI score (table 1). SRBD patients had less slow wave sleep, higher hypoxic load (T90), lower exercise capacity, lower oxygen uptake at the anaerobic threshold and a higher ventilatory CO2 equivalent (figure 1). <b>Conclusion:</b> SRBD in IPF patients are of high prevalence and associated with compromised global cardiopulmonary performance. Increased T90, known to have cognitive, cardiovascular and metabolic consequences, suggests impaired outcome. Increased ventilatory CO2 equivalent might indicate high prevalence of pulmonary hypertension. Due to lack of SRBD symptoms, at least a 2-channel diagnostic is required for screening.