Obstructive sleep apnea should be treated in patients with idiopathic pulmonary fibrosis
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The most recent idiopathic pulmonary fibrosis (IPF) guidelines include obstructive sleep apnea (OSA) among the IPF-associated comorbidities. Furthermore, they recognize the paucity of studies related to continuous positive airway pressure(CPAP) treatment in this patient group and call for intensive research in this field. Our aim was to assess the effect of CPAP treatment on sleep and overall life quality parameters, morbidity, and mortality in IPF patients with OSA.
Ninety-two treatment-naive, newly diagnosed, consecutive IPF patients underwent overnight-attended polysomnography (PSG). In those patients with an apnea-hypopnea index (AHI) of ≥15, therapy with CPAP was initiated. Patients were divided into poor and good CPAP compliance groups. All subjects completed multiple quality-of-life and sleep instruments before CPAP initiation and at 1 year after the start of CPAP treatment.
The good CPAP compliance group (37 patients) showed statistically significant improvement in all quality-of-life and sleep instruments after 1 year’s CPAP treatment. The poor CPAP compliance group (18 patients) showed significant changes of smaller strength only in a minority of the used instruments. During the 24-month follow-up period after CPAP initiation, three patients from the CPAP poor compliance group died, whereas all patients from the good CPAP compliance group remained alive.
Early OSA recognition and treatment is crucial in a fatal disease such as IPF. Effective CPAP treatment in IPF patients with OSA results in a significant improvement in daily living activities and quality of sleep and life. Good CPAP compliance appears to improve mortality.
KeywordsIdiopathic pulmonary fibrosis Obstructive sleep apnea syndrome CPAP therapy Quality of life and sleep IPF mortality
Conflict of interest
All the authors declare that they have no conflict of interest.
- 1.An Official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management (2011) Am J Respir Crit Care Med 183:788–824Google Scholar
- 18.Iber C, Ancoli-Israel S, Chesson A, Quan SF, editors (2007) 1st ed. Westchester, IL: American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specificationGoogle Scholar
- 28.Hjollund N, Andersen J, Bech P (2007) Assessment of fatigue in chronic disease: a bibliographic study of fatigue measurement scales. Health Qual Life Outcome 27:5–12Google Scholar