成年囊性纤维化患者睡眠状况的性别差异以及依列卡福/替扎卡福/艾伐卡福对睡眠质量的影响：一项前瞻性观察研究
Sex Differences in Sleep Profiles and the Effect of Elexacaftor/Tezacaftor/Ivacaftor on Sleep Quality in Adult People with Cystic Fibrosis: A Prospective Observational Study.
作者信息
Dietz-Terjung Sarah, Straßburg Svenja, Schulte Tim, Dietz Paul, Weinreich Gerhard, Taube Christian, Schöbel Christoph, Welsner Matthias, Sutharsan Sivagurunathan
机构信息
Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Adult Cystic Fibrosis Center, University of Duisburg-Essen, Tueschener Weg 40, 45329 Essen, Germany.
Department of Sleep and Telemedicine, University Hospital Essen-Ruhrlandklinik, University of Duisburg-Essen, 45239 Essen, Germany.
出版信息
Diagnostics (Basel). 2024 Dec 19;14(24):2859. doi: 10.3390/diagnostics14242859.
BACKGROUND/OBJECTIVES: Recent studies indicate that sleep and sleep disorders differ between men and women, but corresponding data in people with chronic lung diseases are lacking. This study aims to answer the question of what the sex-specific differences in sleep profiles and responses to elexacaftor/tezacaftor/ivacaftor (ETI) therapy in people with cystic fibrosis (pwCF) are.
METHODS
Adult pwCF and a matched control group (adults with suspected sleep-disordered breathing undergoing in-laboratory polysomnography (PSG)) were included. PSG data at baseline and after 6 months' ETI therapy were compared between men (mwCF) and women (wwCF) with cystic fibrosis. PSG data at baseline and 6-month follow-up for mwCF/wwCF were compared with baseline PSG data for men/women in the control group. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). Correlations between change in percentage predicted forced expiratory volume in 1 s from baseline to 6 months were correlated with corresponding changes in key sleep parameters. Changes in transferrin during ETI therapy were also documented.
RESULTS
Twenty-eight pwCF (12 wwCF, 16 mwCF) and 28 matched controls were included. Both mwCF (4 ± 5 vs. 9 ± 20 events/h, = 0.028) and wwCF (3 ± 3 vs. 8 ± 9 events/h, = 0.004) had fewer respiratory events during sleep versus male and female controls, but worse sleep efficiency (75 ± 11% vs. 84 ± 11%; = 0.004 and 76 ± 10% vs. 83 ± 11%; = 0.011. The baseline ESS score was significantly higher in wwCF versus female controls (8 ± 4 vs. 14 ± 8; = 0.040). Although some sleep parameters normalized during ETI therapy in pwCF, sleep quality remained poor. The transferrin levels at baseline (2.7 ± 0.4 vs. 2.2 ± 0.5; = 0.049) and 6 months (3.8 ± 0.4 vs. 2.6 ± 0.5; < 0.001) were significantly higher in the wwCF versus the mwCF, and the change from baseline during ETI therapy was significantly greater in women versus men (1.1 ± 0.6 vs. 0.4 ± 0.4; < 0.001).
CONCLUSIONS
These data suggest that wwCF and mwCF should be managed differently with respect to their sleep.
背景/目的：近期研究表明，男性和女性的睡眠及睡眠障碍存在差异，但慢性肺部疾病患者的相关数据尚缺。本研究旨在回答囊性纤维化患者（pwCF）在睡眠特征以及对依列卡福/替扎卡福/依伐卡福（ETI）治疗反应方面的性别差异问题。
方法
纳入成年pwCF患者及匹配的对照组（疑似睡眠呼吸障碍的成年人，接受实验室多导睡眠图（PSG）检查）。比较囊性纤维化男性患者（mwCF）和女性患者（wwCF）在基线及ETI治疗6个月后的PSG数据。将mwCF/wwCF在基线及6个月随访时的PSG数据与对照组男性/女性的基线PSG数据进行比较。使用爱泼沃斯思睡量表（ESS）评估日间嗜睡情况。记录从基线到6个月1秒用力呼气量预测值百分比变化与关键睡眠参数相应变化之间的相关性。还记录了ETI治疗期间转铁蛋白的变化情况。
结果
纳入28例pwCF患者（12例wwCF，16例mwCF）和28例匹配的对照者。与男性和女性对照者相比，mwCF（4±5次/小时 vs. 9±20次/小时，P = 0.028）和wwCF（3±3次/小时 vs. 8±9次/小时，P = 0.004）睡眠期间的呼吸事件均较少，但睡眠效率较差（75±11% vs. 84±11%；P = 0.004和76±10% vs. 83±11%；P = 0.011）。与女性对照者相比，wwCF的基线ESS评分显著更高（8±4 vs. 14±8；P = 0.040）。尽管pwCF患者在ETI治疗期间一些睡眠参数恢复正常，但睡眠质量仍较差。与mwCF相比，wwCF在基线时（2.7±0.4 vs. 2.2±0.5；P = 0.049）和6个月时（3.8±0.4 vs. 2.6±0.5；P<0.001）的转铁蛋白水平显著更高，且ETI治疗期间女性相对于男性从基线的变化显著更大（1.1±0.6 vs. 0.4±0.4；P<0.001）。
结论
这些数据表明，wwCF和mwCF在睡眠管理方面应区别对待。
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