Research Article
Volume 9 Issue 6 - 2020
Sleep Apnea in Individuals with Idiopathic Pulmonary Fibrosis
Pamela Di Giovanni1, Tommaso Staniscia2, Lorenzo Migliorato3, Francesca Guido3, Pierpaolo Prosperi4 and Antonella Spacone4*
1Department of Pharmacy, “G. d’Annunzio” University of Chieti, Pescara, Italy
2Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti, Pescara, Italy
3Radiology Division, “Santo Spirito” Hospital, Pescara, Italy
4Respiratory Medicine Unit, “Santo Spirito” Hospital, Pescara, Italy
*Corresponding Author: Antonella Spacone, Respiratory Medicine Unit, “Santo Spirito” Hospital, Pescara, Italy.
Received: May 01, 2020; Published: May 12, 2020




Abstract

Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive lung disease with high mortality. It is characterized by a progressive heterogeneous course, with a median survival of 2.5 to 4.5 years and few treatment options.

IPF is associated with significant comorbidities such as pulmonary hypertension, emphysema, pulmonary lung cancer, pulmonary thromboembolism, coronary artery disease, gastroesophageal reflux disease and obstructive sleep apnea (OSA).

Several studies have reported different incidence frequency of obstructive sleep apnea (OSA) in interstitial lung disease (ILD). 

Objectives: The aims of this study were to evaluate the frequency of sleep apnea in 24 stable IPF patients, to describe clinical and home sleep test (HST) features of sleep-related breathing disorders and to analyze the relationship among the indexes HST findings (apnea/ipopnea index - AHI), pulmonary function (forced vital capacity - FVC%, diffusing capacity of the lung for carbon monoxide - DLco) and sleep questionnaires.

Materials and Methods: We synthesized categorical variables as frequencies and percentages and continuous variables as mean and standard deviation (SD). In order to test for differences in characteristics of IPF/OSA group according the gender and severity of OSA scores, One-way analyses of variance and independent sample t-test were performed.

Results: 24 patients were recruited, 22 (91.7%) of which were positive for OSA (mild OSA was detected in 59.1%, moderate in 22.7%, and severe in 18.2%). The mean AHI was 20.7 ± 15.9/h, the mean oxy-haemoglobin saturation was 90.7 ± 2.3% and mean time of oxy-haemoglobin saturation lower than 90% was of 23.5 ± 23.2%. Mean FVC% was 90.1 ± 19.2%, mean DLco was 53.1 ± 16.7%; 15 patients had GAP I. Only one patient presented symptoms suggestive of OSA. The patients presented more events of hypopnea (I/h) than apnea (A/h); this condition was more evident in females than in men. Nocturnal respiratory failure was found associated to OSA in 18%.

Conclusion: In our study, the prevalence of sleep disordered breathing in patients with IPF was very high and the most frequent event was hypopnea. We concluded that the sleep study should be considered as part of the assessment in managing patients with IPF. The therapeutic approach of IPF cannot be limited to the administration of antifibrotic drugs: identification and treatment of complicating comorbidities such as OSA may have a significant impact on patient’s survival and quality of life.

Keywords: Obstructive Sleep Apnea; Idiopathic Pulmonary Fibrosis

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Citation: Antonella Spacone., et al. “Sleep Apnea in Individuals with Idiopathic Pulmonary Fibrosis”. EC Pulmonology and Respiratory Medicine 9.6 (2020): 31-38.

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