Guy's and St Thomas' NHS Foundation Trust, London, England.
Guy's and St Thomas' NHS Foundation Trust, London, England.
Chest. 2023 Nov;164(5):1232-1242. doi: 10.1016/j.chest.2023.05.013. Epub 2023 May 13.
OSA and nocturnal hypoxemia (NH) are common in patients with fibrotic interstitial lung disease (F-ILD), but their relationship with disease outcomes remains unclear.
What is the relationship between NH and OSA and clinical outcomes in patients with F-ILD?
This was a prospective observational cohort study of patients with F-ILD and without daytime hypoxemia. Patients underwent home sleep study at baseline and were followed up for at least 1 year or until death. NH was defined as ≥ 10% of sleep with oxygen saturation of < 90%. OSA was defined as an apnea-hypopnea index of ≥ 15 events/h.
Among 102 participants (male, 74.5%; age, 73.0 ± 8.7 years; FVC, 2.74 ± 0.78 L; 91.1% idiopathic pulmonary fibrosis), 20 patients (19.6%) demonstrated prolonged NH and 32 patients (31.4%) showed OSA. No significant differences were found between those with and without NH or OSA at baseline. Despite this, NH was associated with a more rapid decline in both quality of life as measured by the King's Brief Interstitial Lung Disease questionnaire (change, -11.3 ± 5.3 points in the NH group vs -6.7 ± 6.5 in those without NH; P = .005) and higher all-cause mortality at 1 year (hazard ratio, 8.21; 95% CI, 2.40-28.1; P < .001). No statistically significant difference was seen between the groups in annualized change in measures of pulmonary function testing.
Prolonged NH, but not OSA, is associated with worsening disease-related quality of life and increased mortality in patients with F-ILD.
阻塞性睡眠呼吸暂停（OSA）和夜间低氧血症（NH）在纤维化间质性肺疾病（F-ILD）患者中较为常见，但它们与疾病结局的关系尚不清楚。
NH 和 OSA 与 F-ILD 患者的临床结局有何关系？
这是一项前瞻性观察性队列研究，纳入了无日间低氧血症的 F-ILD 患者。患者在基线时进行家庭睡眠研究，并至少随访 1 年或直至死亡。NH 定义为 10%以上的睡眠时间血氧饱和度＜90%。OSA 定义为每小时呼吸暂停低通气指数≥15 次。
在 102 名参与者（男性占 74.5%；年龄 73.0±8.7 岁；FVC 2.74±0.78L；91.1%为特发性肺纤维化）中，20 名（19.6%）患者存在 NH 延长，32 名（31.4%）患者存在 OSA。尽管如此，NH 组和无 NH 组患者在基线时无显著差异。尽管如此，NH 与生活质量下降更快相关（King's 简短间质性肺疾病问卷评分的变化，NH 组为-11.3±5.3 分，无 NH 组为-6.7±6.5 分；P=0.005），1 年时全因死亡率更高（风险比，8.21；95%CI，2.40-28.1；P＜0.001）。两组患者的肺功能检测指标的年化变化无统计学差异。
与 OSA 相比，NH 延长与 F-ILD 患者的疾病相关生活质量恶化和死亡率增加相关。
