Arch Pediatr Adolesc Med. 2012 Oct 22:1-5. doi: 10.1001/archpediatrics.2012.1177. [Epub ahead of print]

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

Spicuzza L, Sciuto C, Leonardi S, La Rosa M.

Abstract

OBJECTIVES To assess the occurrence of sleep-disordered breathing, hypoxemia, and sleep architecture in a cohort of infants and children withcystic fibrosis (CF) and normal or mildly impaired lung function in stable clinical condition. DESIGN Case-control study. SETTING Cystic FibrosisUnit of a university hospital and pediatric sleep laboratory. PARTICIPANTS A total of 40 children (aged 6 months to 11 years) with CF in stable condition and 18 healthy age-matched control subjects. 

INTERVENTION Nocturnal sleep and cardiorespiratory monitoring was performed using a full polysomnographic recording in a sleep laboratory. 

MAIN OUTCOMES MEASURES Sleep architecture and respiratory variables. 

RESULTS Although awake oxyhemoglobin saturation (SaO2) values were similar in the 2 groups (98%), the CF group had significantly lower values of nocturnal mean SaO2. 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). 

CONCLUSIONS This 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.