title: Predictors of obstructive sleep apnea in lung transplant recipients.
abstract: The aim of our study was to determine the prevalence and clinical predictors of obstructive sleep apnea in lung transplantation recipients.
  
  
  
  In a cross-sectional analysis we studied 77 clinically stable lung transplant recipients (45 men, time range after lung transplantation [LTX]: from one month to 15 years). Indications for LTX were 36 chronic obstructive lung disease (COPD), 27 idiopathic pulmonary fibrosis (IPF), eight cystic fibrosis, and six others. In-lab polysomnography (PSG) was performed to investigate sleep characteristics. Obstructive sleep apnea (OSA) and central sleep apnea were defined by an apnea-hypopnea index (AHI) ≥ 10/h.
  
  
  
  The prevalence of OSA and central sleep apnea (CSA) were 42.9% and 6.5%, respectively. OSA was present in 61% of patients with pre-transplant COPD and 52% of patients with pre-transplant IPF. Univariate analysis showed that OSA was significantly associated with neck circumference per 1-cm size increment (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.04-1.42, p = 0.01) and pre-transplant COPD/IPF vs other lung diseases (cystic fibrosis, pulmonary arterial hypertension, α-1 antitrypsin deficiency, and lymphangioleiomyomatosis) (OR = 6.89, 95% CI = 1.41-33.56, p = 0.02), whereas age ≥57 years (OR = 1.76, 95% CI = 0.69-4.48, p = 0.24), male gender (OR = 2.33, 95% CI = 0.89-6.01, p = 0.08), and BMI ≥ 24.6 kg/m(2) (OR = 1.73, 95% CI = 0.68-4.40, p = 0.25) did not reach a level of statistical significance. In a multivariate analysis neck circumference per 1-cm size increment (OR = 1.20, 95% CI = 1.02-1.41, p = 0.025) and pre-transplant COPD/IPF (OR = 5.34, 95% CI = 1.01-28.13, p = 0.048) remained independently associated with OSA.
  
  
  
  The prevalence of OSA is high in stable lung transplant recipients. Pre-transplant COPD is an independent predictor of OSA.
authors.affiliation: Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany. Electronic address: urte.sommerwerck@ruhrlandklinik.uk-essen.de.
authors.forename: Urte
authors.initials: U
authors.lastname: Sommerwerck
authors.affiliation: Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany.
authors.forename: Bjoern E
authors.initials: BE
authors.lastname: Kleibrink
authors.affiliation: Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany.
authors.forename: Frederike
authors.initials: F
authors.lastname: Kruse
authors.affiliation: Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany.
authors.forename: Manuela J
authors.initials: MJ
authors.lastname: Scherer
authors.affiliation: Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Thoracic Transplantation, University Hospital Essen, University Duisburg-Essen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Kamler
authors.affiliation: Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Teschler
authors.affiliation: Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Weinreich
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008168:Lung; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D012894:Sleep Stages; D066027:Transplant Recipients
keywords: Lung transplantation; Obstructive sleep apnea