Patsoura Athina, Baldini Giulia, Puggioni Daniele, Delle Vergini Matteo, Castaniere Ivana, Andrisani Dario, Gozzi Filippo, Samarelli Anna Valeria, Raineri Giulia, Michelacci Sofia, Ruini Cristina, Carzoli Andrea, Cuculo Aurelia, Marchioni Alessandro, Beghè Bianca, Clini Enrico, Cerri Stefania, Tonelli Roberto
Respiratory Disease Unit, Department of Medical and Surgical Sciences of Motherhood and Child, University Hospital of Modena, 41125 Modena, Italy.
Experimental Pneumology Laboratory, University of Modena and Reggio Emilia, 41125 Modena, Italy.
J Clin Med. 2025 Mar 24;14(7):2205. doi: 10.3390/jcm14072205.
In recent years, several studies have examined the impact of sleep-disordered breathing (SBD) on the quality of life and prognosis of patients with idiopathic pulmonary fibrosis (IPF). Among these disorders, obstructive sleep apnea (OSA) and nocturnal hypoxemia (NH) are the most prevalent and extensively studied, whereas central sleep apnea (CSA) has only been documented in recent research. The mechanisms underlying the relationship between IPF and SBDs are complex and remain an area of active investigation. Despite growing recognition of SBDs in IPF, no standardized guidelines exist for their management and treatment, particularly in a population characterized by distinct structural pulmonary abnormalities. This review outlines the pathophysiological connections between sleep-breathing disorders (SBDs) and idiopathic pulmonary fibrosis (IPF), as well as current therapeutic options. A comprehensive literature search using PubMed identified relevant studies, confirming the efficacy of CPAP in treating severe OSA and CSA. While high-flow oxygen therapy has not been validated in this patient cohort, it may offer a potential solution for select patients, particularly the elderly and those with low compliance. Conventional oxygen therapy, however, is limited to cases of isolated nocturnal hypoxemia or mild central sleep apnea.
近年来,多项研究探讨了睡眠呼吸障碍(SBD)对特发性肺纤维化(IPF)患者生活质量和预后的影响。在这些疾病中,阻塞性睡眠呼吸暂停(OSA)和夜间低氧血症(NH)最为常见且研究广泛,而中枢性睡眠呼吸暂停(CSA)仅在最近的研究中有所记载。IPF与SBD之间关系的潜在机制复杂,仍是一个积极研究的领域。尽管IPF患者中对SBD的认识不断提高,但对于其管理和治疗尚无标准化指南,尤其是在具有明显肺部结构异常特征的人群中。本综述概述了睡眠呼吸障碍(SBD)与特发性肺纤维化(IPF)之间的病理生理联系以及当前的治疗选择。使用PubMed进行的全面文献检索确定了相关研究,证实了持续气道正压通气(CPAP)治疗重度OSA和CSA的疗效。虽然高流量氧疗在该患者队列中尚未得到验证,但它可能为特定患者,尤其是老年人和依从性低的患者提供一种潜在的解决方案。然而,传统氧疗仅限于孤立性夜间低氧血症或轻度中枢性睡眠呼吸暂停的病例。