Cystic fibrosis patients have poor sleep quality despite normal sleep latency and efficiency.
OBJECTIVE
Cystic fibrosis (CF) patients may be predisposed to poor sleep quality due to upper and lower airway abnormalities and impaired gas exchange. Previous sleep investigations of CF patients using single-night polysomnography have reported conflicting results. We hypothesized that sampling sleep for a prolonged period in a patient's normal environment may give a more representative assessment of sleep quality than a single-night polysomnogram, and that impaired sleep quality would correlate with pulmonary disease severity and self-assessed sleep quality.


METHODS
Using wrist actigraphy, we measured sleep quality in clinically stable CF patients and age-matched control subjects. In addition, each CF patient and control subject completed the following three questionnaires: the Epworth sleepiness scale; the Pittsburgh sleep quality index (PSQI); and the Medical Outcomes Study 36-item short form.


RESULTS
Twenty CF patients and control subjects were enrolled in the study, and were well-matched for age, sex, and body mass index. The mean (+/- SD) FEV(1) for CF patients was 61.0 +/- 20.1% predicted. CF patients and control subjects had similar sleep duration, sleep latency, and sleep efficiency. However, CF patients had higher PSQI scores (6.45 vs 4.55, respectively; p = .04), a higher fragmentation index (FI) [31.72 vs 18.02, respectively; p < 0.001], and less immobile time (88.87 vs 91.89, respectively; p = 0.02). There was a significant correlation of FI with FEV(1) and PSQI scores.


CONCLUSIONS
Stable CF patients have disrupted sleep, and sleep disruption may in part be related to the severity of pulmonary disease. In addition, the PSQI may be useful in detecting CF patients with poor sleep quality.
Jankelowitz
Larry
L
Department of Medicine, Northwestern University Medical School, Chicago, IL 60611, USA.
Reid
Kathryn J
KJ
Wolfe
Lisa
L
Cullina
Joanne
J
Zee
Phyllis C
PC
Jain
Manu
M
D000328:Adult; D003550:Cystic Fibrosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000379:methods*; D011659:Pulmonary Gas Exchange; D012890:Sleep / Q000502:physiology; D012892:Sleep Deprivation; D011795:Surveys and Questionnaires; D013997:Time Factors