Sleep and Respiratory Parameters After Lung Transplantation in Adult Patients With Cystic Fibrosis

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-11-14 DOI:10.1111/ctr.70023

Alexandros Kalkanis, Dimitrios Papadopoulos, Robin Vos, Lieven Dupont, Bertien Buyse, Dries Testelmans

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Abstract

Objective

We aimed to explore the prevalence and predictive factors of sleep-disordered breathing (SDB) in patients with cystic fibrosis (pwCF) after lung transplantation (LTX).

Methods

We prospectively recruited adult pwCF who underwent LTX in our hospital from 2013 to 2022 and invited them for an attended overnight polysomnography (PSG) 1 year after transplantation. The apnea–hypopnea index (AHI) was the primary outcome, and SDB was defined as an AHI ≥ 5. Demographic, anthropometric, cardiometabolic, drug treatment, and pulmonary function variables were compared between pwCF with and without SDB. Multiple regression analysis was used to identify significant predictors of SDB. For a subset of participants who had available PSG before transplantation, sleep parameters were compared pre-post transplantation.

Results

Sixty-two pwCF (31 females) were enrolled. Thirty participants had SDB, but only 11 of them had moderate-to-severe SDB (AHI ≥ 15). The average Epworth Sleepiness Scale (ESS) score indicated the absence of excessive daytime sleepiness. Older age (p < 0.001), male sex (p < 0.001), and smaller thoracic gas volume (p = 0.002) significantly predicted higher AHI. Comparison between pre- and post-transplantation polysomnographic data showed a significant increase in the percentage of slow wave sleep (p = 0.047), as well as a significant improvement in mean nocturnal oxygen saturation (p = 0.007). A statistically significant increase in the AHI was also observed (p = 0.047), but its clinical importance is uncertain (p = 0.476 for the increase in the ESS score).

Conclusions

We may conclude that SDB is prevalent in pwCF after LTX, but its severity is mild. Older male pwCF with greater improvement in lung hyperinflation after transplantation might be at risk for SDB and should be followed for symptoms or signs of sleep apnea.

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囊性纤维化成年患者肺移植后的睡眠和呼吸参数

目的我们旨在探讨肺移植（LTX）后囊性纤维化患者（pwCF）睡眠呼吸障碍（SDB）的患病率和预测因素：我们前瞻性地招募了2013年至2022年期间在我院接受肺移植手术的成年囊性纤维化患者，并邀请他们在移植手术1年后参加一次通宵多导睡眠图（PSG）检查。呼吸暂停-低通气指数（AHI）是主要结果，AHI≥5定义为SDB。对有和没有 SDB 的 pwCF 的人口统计学、人体测量、心脏代谢、药物治疗和肺功能变量进行了比较。多元回归分析用于确定 SDB 的重要预测因素。对于移植前有 PSG 的参与者，对移植前和移植后的睡眠参数进行了比较：共有 62 名儿童慢性阻塞性肺疾病患者（31 名女性）入组。其中 30 人患有 SDB，但只有 11 人患有中重度 SDB（AHI ≥ 15）。埃普沃思嗜睡量表（ESS）的平均得分表明没有白天过度嗜睡的情况。年龄较大（P我们可以得出结论，SDB 在 LTX 后的肺心病患者中普遍存在，但其严重程度较轻。移植后肺过度充气情况得到较大改善的老年男性患儿可能有发生 SDB 的风险，因此应密切关注他们是否出现睡眠呼吸暂停的症状或体征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.