Effect of pulmonary exacerbation on sleep quality and sleep parameters among adult people with cystic fibrosis.

BACKGROUND

Sleep disorders are an important comorbidity among people with cystic fibrosis (PwCF), which is frequently underdiagnosed. The aim of this study was to investigate the effect of pulmonary exacerbations (PExs) on sleep quality, regarding sleep questionnaires and respiratory parameters.

METHODS

Adult PwCF who are systematically followed up in the Adult CF Unit of "G. Papanikolaou" Hospital in Thessaloniki, Greece, were studied at clinically stable state, at the beginning and at the end of a PEx requiring hospitalization. Participants underwent objective self-evaluation of sleep quality using specific questionnaires -Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Athens Insomnia Scale (AIS)- and polygraphy.

RESULTS

Regarding subjective sleep quality, PEx led to increased scores on all 3 sleep related questionnaires, with a statistically significant change observed in AIS. The number of PwCF with an abnormal score significantly increased at the beginning of a PEx compared to steady state for PSQI and AIS. Self assessed sleep quality improved at the end of a PEx. In polygraphy, a statistical significant increase in the apnea hypopnea index (AHI) was observed at the beginning of a PEx compared with steady state. The mean oxygen saturation (SpO2) during sleep decreased at exacerbation, as well as the minimum nocturnal SpO2. An increase in the percent of sleep time with SpO2 below 90 % was observed at the beginning of a PEx. Sleep parameters returned to baseline at the end of a PEx.

CONCLUSIONS

PExs negatively affect both objective and subjective parameters of sleep quality in adult PwCF.