OSA and Prolonged Oxygen Desaturation During Sleep are Strong Predictors of Poor Outcome in IPF

Marcello Bosi, Giulia Milioli, Francesco Fanfulla, Sara Tomassetti, Jay H Ryu, Liborio Parrino, Silvia Riccardi, Andrea Melpignano, Anna Elisabetta Vaudano, Claudia Ravaglia, Paola Tantalocco, Andrea Rossi, Venerino Poletti

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13 Scopus citations

Abstract

Purpose: Sleep Breathing Disorders (SBD) are frequently found in idiopathic pulmonary fibrosis (IPF) and they are associated with worse quality of sleep and life and with higher mortality. The study aimed at evaluating the impact of SBD on prognosis (mortality or disease progression) in 35 patients with mild to moderate IPF. Methods and Results: Obstructive sleep apnea (OSA) was diagnosed in 25/35 patients with IPF: 14/35 mild, 7/35 moderate, and 4/35 severe. According to the American Academy of Sleep Medicine (AASM) definition, sleep-related hypoxemia was found in 9/35 patients with IPF. According to the presence/absence of SBD, IPF patients were divided into 4 groups: NO-SBD group (Group A, 25.7%), OSA without sleep-related hypoxemia (Group B, 48.5%), OSA with sleep-related hypoxemia group (Group C, 22.8%), and only 1/35 had sleep-related hypoxemia without OSA(Group D, 2.8%). Statistical analysis was focused only on group A, B, and C. Patients with OSAS and sleep-related hypoxemia (Group C) had the worse prognosis, both in terms of mortality or clinical deterioration. SBD were the only independent risk factor (Cox Proportional Hazards Multiple Regression Analysis) for mortality (HR 7.6% IC 1.2–36.3; p = 0.029) and disease progression (HR 9.95% IC 1.8–644.9; p = 0.007). Conclusions: SBD are associated with a worse prognosis, both in terms of mortality or clinical progression. The presence of SBD should be explored in all IPF patients.

Original languageEnglish (US)
Pages (from-to)643-651
Number of pages9
JournalLung
Volume195
Issue number5
DOIs
StatePublished - Oct 1 2017

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Keywords

  • Idiopathic pulmonary fibrosis
  • Mortality
  • Obstructive sleep apnea
  • Sleep-related hypoxemia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Bosi, M., Milioli, G., Fanfulla, F., Tomassetti, S., Ryu, J. H., Parrino, L., Riccardi, S., Melpignano, A., Vaudano, A. E., Ravaglia, C., Tantalocco, P., Rossi, A., & Poletti, V. (2017). OSA and Prolonged Oxygen Desaturation During Sleep are Strong Predictors of Poor Outcome in IPF. Lung, 195(5), 643-651. https://doi.org/10.1007/s00408-017-0031-4