title: Sleep quality and nocturnal hypoxaemia and hypercapnia in children and young adults with cystic fibrosis.
abstract: OBJECTIVE
  The aim of the study was to evaluate sleep quality and nocturnal gas exchange in patients with cystic fibrosis (CF) and to assess if sleep quality and daytime lung function could predict nocturnal hypoxaemia or hypercapnia.
  
  
  METHODS
  Daytime sleepiness and objective sleep quality were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and actigraphy in 25 children and 55 young adults (mean age 24±10 years, forced expiratory volume in 1 s (FEV(1)) 41±11% predicted). Nocturnal gas exchange was assessed by pulse oximetry (SpO(2)) and transcutaneous carbon dioxide (PtcCO(2)) recordings. Eleven patients underwent simultaneous polysomnography (PSG).
  
  
  RESULTS
  PSQI was 6.3±3.4 with 51% of the patients having a score >5 corresponding to significant sleep complaints. On actigraphy, sleep efficiency was impaired at 79±11% with a fragmentation index at 41±18. Mean nocturnal SpO(2) was 93±3% with 18% of the patients exhibiting >10% of night time spent with a value below 90%. Mean PtcCO(2) was 44±6 mm Hg with 47% of the patients exhibiting >10% of night time with a value >45 mm Hg. Daytime arterial blood gases correlated with nocturnal gas exchange. FEV(1) was the only lung function parameter that correlated with nocturnal SpO(2) (p<0.01). Compared with PSG, SpO(2) and PtcCO(2) accurately identified rapid eye movement sleep hypoventilation.
  
  
  CONCLUSIONS
  Patients with CF exhibit poor sleep quality that does not predict nocturnal gas exchange. Nocturnal hypoxaemia and hypercapnia can be identified by simple tools.
authors.affiliation: AP-HP, Pediatric Pulmonary Department, Hôpital Armand Trousseau, Université Pierre et Marie Curie - Paris 6, INSERM U 955, 28 avenue du Docteur Arnold Netter, Paris, France. brigitte.fauroux@trs.aphp.fr
authors.forename: Brigitte
authors.initials: B
authors.lastname: Fauroux
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pepin
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Boelle
authors.forename: Claire
authors.initials: C
authors.lastname: Cracowski
authors.forename: Marlène
authors.initials: M
authors.lastname: Murris-Espin
authors.forename: Raphaele
authors.initials: R
authors.lastname: Nove-Josserand
authors.forename: Nathalie
authors.initials: N
authors.lastname: Stremler
authors.forename: Tabassome
authors.initials: T
authors.lastname: Simon
authors.forename: Pierre-Régis
authors.initials: PR
authors.lastname: Burgel
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D000328:Adult; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D000860:Hypoxia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D010092:Oximetry; D017286:Polysomnography; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012890:Sleep / Q000502:physiology*; D011795:Surveys and Questionnaires; D055815:Young Adult