Mermigkis C, Stagaki E, Amfilochiou A, Polychronopoulos V, Korkonikitas P, Mermigkis D, Bregou M, Kouris N, Bouros D
Third Pulmonary Department, Sismanoglion General District Hospital, Athens, Greece.
Med Princ Pract. 2009;18(1):10-5. doi: 10.1159/000163039. Epub 2008 Dec 4.
The aim of this study was to describe sleep quality and associated daytime consequences in idiopathic pulmonary fibrosis (IPF).
Fifteen patients with IPF and 15 control subjects matched on age and anthropometric variables were included in the study. Sleep quality and its daytime consequences were assessed by clinical interview, the Pittsburgh Sleep Quality Index (PSQI), the Functional Outcomes in Sleep Questionnaire (FOSQ), the Fatigue Severity Scale (FSS), the Epworth Sleepiness Scale and attended all-night polysomnography.
Polysomnography revealed a decrease in sleep efficiency and slow wave sleep, and an increase in stage 1 sleep and arousal index in IPF patients compared to controls. Daytime tachypnea persisted during sleep. Oxygen saturation below 90% was observed during 34.3 +/- 37.3% of the total sleep time (TST). Quality of sleep and daytime function were moderately to significantly impaired based on the PSQI and FOSQ. The total FOSQ score was negatively correlated with TST with oxygen saturation below 90% (p = 0.01, r = -0.62). FSS scores were correlated with TST at oxygen saturation below 90% and mean oxygen saturation during sleep (p = 0.002, r = 0.74, and p = 0.007, r = -0.66, respectively).
Our data suggest significant sleep disruption and consequent impairment of physical and social functioning in patients with IPF. In the absence of effective treatments for IPF, the improvement of sleep quality should be a primary therapeutic goal.
本研究旨在描述特发性肺纤维化（IPF）患者的睡眠质量及其相关的日间后果。
本研究纳入了15例IPF患者以及15例在年龄和人体测量学变量上相匹配的对照受试者。通过临床访谈、匹兹堡睡眠质量指数（PSQI）、睡眠问卷功能结局量表（FOSQ）、疲劳严重程度量表（FSS）、爱泼华嗜睡量表对睡眠质量及其日间后果进行评估，并进行整夜多导睡眠监测。
多导睡眠监测显示，与对照组相比，IPF患者的睡眠效率和慢波睡眠减少，1期睡眠和觉醒指数增加。日间呼吸急促在睡眠期间持续存在。在总睡眠时间（TST）的34.3±37.3%期间观察到氧饱和度低于90%。基于PSQI和FOSQ，睡眠质量和日间功能受到中度至显著损害。FOSQ总分与氧饱和度低于90%的TST呈负相关（p = 0.01，r = -0.62）。FSS评分与氧饱和度低于90%的TST以及睡眠期间的平均氧饱和度相关（分别为p = 0.002，r = 0.74，以及p = 0.007，r = -0.66）。
我们的数据表明，IPF患者存在明显的睡眠障碍，进而导致身体和社会功能受损。在缺乏针对IPF的有效治疗方法的情况下，改善睡眠质量应成为主要的治疗目标。
