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Predictors of sleep hypoxemia in children with cystic fibrosis

Amal Isaiah1, Amine Daher2, Preeti B Sharma2

  • 1Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Dallas, Texas.

Pediatric Pulmonology
|January 5, 2019
PubMed

Insights

In children with cystic fibrosis (CF), lung function (percent predicted forced expiratory volume in one second, pFEV1) best predicts nocturnal hypoxemia. Clinical factors did not predict sleep-related oxygen desaturation in this study.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Cystic Fibrosis Research

Background:

  • Nocturnal hypoxemia is a concern in children with cystic fibrosis (CF).
  • Identifying predictors of hypoxemia is crucial for timely intervention.
  • Previous studies have explored various factors, but a clear predictor in this population remained elusive.

Purpose of the Study:

  • To determine the key determinants of nocturnal hypoxemia in pediatric CF patients.
  • To investigate the predictive value of clinical parameters, polysomnography (PSG), and lung function tests.

Main Methods:

  • A retrospective case series design was employed.
  • Included were 35 children (aged 5-18 years) with CF and available concurrent PSG and pFEV1 data.
  • Regression analysis assessed the impact of demographic, clinical, PSG, and pFEV1 variables on time spent with oxygen saturation below 90% (TSpO2 < 90).

Main Results:

  • No demographic or clinical variables predicted hypoxemia severity.
  • Polysomnography (PSG) variables and pFEV1 significantly explained the variance in nocturnal hypoxemia (R² = 0.53, P < 0.001).
  • Percent predicted forced expiratory volume in one second (pFEV1) emerged as the single best predictor, with a cut-off of 53% showing high sensitivity (0.80) and specificity (0.87).

Conclusions:

  • Lung function, specifically pFEV1, is the primary predictor of sleep hypoxemia in children with CF undergoing PSG.
  • Demographic and clinical factors were not found to be significant predictors in this cohort.
  • These findings highlight the importance of monitoring lung function to anticipate and manage nocturnal hypoxemia in pediatric CF patients.
Abstract

Keywords:
cystic fibrosispulmonary function testingsleep medicine

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