Sleep-related breathing disorders in idiopathic pulmonary fibrosis are frequent and may be associated with pulmonary vascular involvement

Hagmeyer, Lars, Herkenrath, Simon-Dominik, Treml, Marcel, Pietzke-Calcagnile, Anja, Anduleit, Norbert and Randerath, Winfried . Sleep-related breathing disorders in idiopathic pulmonary fibrosis are frequent and may be associated with pulmonary vascular involvement. Sleep Breath.. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1522-1709

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DOI:10.1007/s11325-022-02686-z

Abstract

Purpose Sleep-related breathing disorders (SRBD) may be associated with a worse prognosis in idiopathic pulmonary fibrosis (IPF). However, the prevalence of sleep disorders in IPF and the pathophysiological link between SRBD and IPF is unclear. Patients and methods In this prospective trial, consecutive patients with stable IPF underwent polysomnography and cardiopulmonary exercise testing. Epworth sleepiness scale, Regensburg insomnia scale, and Pittsburgh sleep quality index were evaluated. Exclusion criteria were oxygen supplementation therapy, lung emphysema, and heart failure. For pairwise comparison of categorical data, the two-proportion z-test was applied. Correlation between continuous variables was assessed via the Pearson correlation coefficient. Patients without and with SRBD were compared. To find predictors for SRBD in IPF, multivariable logistic regression was applied. Results A total of 74 IPF patients were evaluated and 45 patients (11 female, median age 74 years, forced vital capacity 71.3%, DLCO 53.9%) were analyzed. Any kind of sleep disorder was found in 89% of patients. SRBD was present in 49% (81% obstructive sleep apnea, 19% central sleep apnea), insomnia in 40%, and periodic leg movements in 47% of subjects. The SRBD subgroup presented with a significantly lower performance (workload(peak)%pred 86.5 vs. 101.0 (p = 0.036); V ' O-2(AT) 618.5 ml/min vs. 774.0 ml/min (p = 0.043)) and exhibited a significantly higher V ' E/V ' CO2(peak) of 43.0 l/l vs. 38.5 l/l (p = 0.037). In search of predictors for SRBD by logistic regression, workload(peak)%pred was identified as a significant variable (p = 0.033). Conclusions SRBD is frequent in IPF. Pulmonary vascular limitations may represent the pathophysiological link between IPF and SRBD. Workload(peak)%pred may be an independent risk factor for the occurrence of SRBD.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Hagmeyer, Lars	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Herkenrath, Simon-Dominik	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Treml, Marcel	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Pietzke-Calcagnile, Anja	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Anduleit, Norbert	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Randerath, Winfried	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED