AP-HP, Pediatric Pulmonary Department, Hôpital Armand Trousseau, Université Pierre et Marie Curie - Paris 6, INSERM U 955, 28 avenue du Docteur Arnold Netter, Paris, France.
Arch Dis Child. 2012 Nov;97(11):960-6. doi: 10.1136/archdischild-2011-300440. Epub 2012 Sep 15.
The aim of the study was to evaluate sleep quality and nocturnal gas exchange in patients with cystic fibrosis (CF) and to assess if sleep quality and daytime lung function could predict nocturnal hypoxaemia or hypercapnia.
Daytime sleepiness and objective sleep quality were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and actigraphy in 25 children and 55 young adults (mean age 24±10 years, forced expiratory volume in 1 s (FEV(1)) 41±11% predicted). Nocturnal gas exchange was assessed by pulse oximetry (SpO(2)) and transcutaneous carbon dioxide (PtcCO(2)) recordings. Eleven patients underwent simultaneous polysomnography (PSG).
PSQI was 6.3±3.4 with 51% of the patients having a score >5 corresponding to significant sleep complaints. On actigraphy, sleep efficiency was impaired at 79±11% with a fragmentation index at 41±18. Mean nocturnal SpO(2) was 93±3% with 18% of the patients exhibiting >10% of night time spent with a value below 90%. Mean PtcCO(2) was 44±6 mm Hg with 47% of the patients exhibiting >10% of night time with a value >45 mm Hg. Daytime arterial blood gases correlated with nocturnal gas exchange. FEV(1) was the only lung function parameter that correlated with nocturnal SpO(2) (p<0.01). Compared with PSG, SpO(2) and PtcCO(2) accurately identified rapid eye movement sleep hypoventilation.
Patients with CF exhibit poor sleep quality that does not predict nocturnal gas exchange. Nocturnal hypoxaemia and hypercapnia can be identified by simple tools.
本研究旨在评估囊性纤维化（CF）患者的睡眠质量和夜间气体交换情况，并评估睡眠质量和日间肺功能是否可预测夜间低氧血症或高碳酸血症。
通过匹兹堡睡眠质量指数（PSQI）和活动记录仪评估 25 名儿童和 55 名年轻成年人（平均年龄 24±10 岁，用力呼气量 1 秒（FEV（1））为预测值的 41±11%）的日间嗜睡和客观睡眠质量。通过脉搏血氧仪（SpO（2））和经皮二氧化碳（PtcCO（2））记录评估夜间气体交换。11 名患者接受了同步多导睡眠图（PSG）检查。
PSQI 评分为 6.3±3.4，其中 51%的患者评分>5，表明存在明显的睡眠问题。在活动记录仪上，睡眠效率为 79±11%，碎片指数为 41±18。平均夜间 SpO（2）为 93±3%，18%的患者夜间有>10%的时间 SpO（2）值低于 90%。平均 PtcCO（2）为 44±6mmHg，47%的患者夜间有>10%的时间 PtcCO（2）值>45mmHg。日间动脉血气与夜间气体交换相关。FEV（1）是唯一与夜间 SpO（2）相关的肺功能参数（p<0.01）。与 PSG 相比，SpO（2）和 PtcCO（2）可准确识别快速眼动睡眠低通气。
CF 患者的睡眠质量较差，但不能预测夜间气体交换。夜间低氧血症和高碳酸血症可通过简单的工具识别。
