Early Occurrence of Obstructive Sleep Apnea in Infants and Children With Cystic Fibrosis

Abstract

ObjectivesTo assess the occurrence of sleep-disordered breathing, hypoxemia, and sleep architecture in a cohort of infants and children with cystic fibrosis (CF) and normal or mildly impaired lung function in stable clinical condition.DesignCase-control study.SettingCystic Fibrosis Unit of a university hospital and pediatric sleep laboratory.ParticipantsA total of 40 children (aged 6 months to 11 years) with CF in stable condition and 18 healthy age-matched control subjects.InterventionNocturnal sleep and cardiorespiratory monitoring was performed using a full polysomnographic recording in a sleep laboratory.Main Outcomes MeasuresSleep architecture and respiratory variables.ResultsAlthough awake oxyhemoglobin saturation (SaO₂) values were similar in the 2 groups (98%), the CF group had significantly lower values of nocturnal mean SaO_2. The apnea-hypopnea index was significantly higher in the CF group compared with the controls (mean [SE], 7.3 [1.3] vs 0.5 [0.4], respectively, P < .001), particularly in preschool-aged children and in children with upper airway abnormalities. In addition, 28 (70%) of the 40 children with CF had mild to moderate obstructive sleep apnea (defined as an apnea-hypopnea index >2). Children with CF compared with controls also had reduced sleep efficiency (CF group vs controls mean [SE], 80% [41%] vs 88% [13.1%], P < .001), rapid eye movement sleep duration (11% [0.9%] vs 13% [1%], P < .05), and increased number of arousals per hour (11.0 [10] vs 8.2 [0.7], P < .001).ConclusionsThis study showed an early occurrence of obstructive sleep apnea in children with CF in stable condition, associated with a mild level of sleep disruption. Early routine nocturnal respiratory monitoring is advised in children with CF.