Obstructive sleep apnoea in patients with fibrotic diffuse parenchymal lung disease-characterization and treatment compliance assessment.

Authors:
Nuno Pereira
Nuno Pereira
Centro Hospitalar São João
Ines Neves
Ines Neves
France; Université de Montpellier
Vanessa Santos
Vanessa Santos
Guarulhos University
Brazil
Natalia Melo
Natalia Melo
University of Sao Paulo School of Medicine
Brazil
Patricia Caetano Mota
Patricia Caetano Mota
Centro Hospitalar de São João
Portugal

Can J Respir Ther 2018 1;54(2):35-40. Epub 2018 Aug 1.

Pulmonology Department, Centro Hospitalar São João, Oporto, Portugal.

Introduction: Recent studies have reported a high prevalence of obstructive sleep apnoea (OSA) among patients with diffuse parenchymal lung disease (DPLD), mainly idiopathic pulmonary fibrosis (IPF). Effective OSA treatment appears to have a positive impact on morbidity and mortality in these patients. However, poor compliance to positive airway pressure (PAP) treatment in fibrotic DPLD patients has been reported. The aims of our study were to characterize patients with fibrotic DPLD and OSA and to assess their compliance to PAP treatment.

Methods: Forty-nine patients with fibrotic DPLD underwent level III polysomnography. Auto-adjusting PAP (APAP) treatment was proposed for those patients with moderate-to-severe OSA and those with mild OSA with daytime sleepiness and/or cardiovascular disease. The APAP treatment compliance was assessed after 1 month of therapy.

Results: The distribution of the 49 fibrotic DPLD patients included was as follows: 21 with chronic hypersensitivity pneumonitis, 12 with IPF, 10 with connective-tissue associated DPLD, 4 with stage IV sarcoidosis, 1 with idiopathic pleuropulmonary fibroelastosis, and 1 with DPLD-associated vasculitis. Thirty-four (69.4%) of the patients presented with OSA; 22 had mild OSA, and 12 had moderate-to-severe OSA. APAP treatment was prescribed in 17 of the patients. After 1 month of therapy, all patients used APAP more than 70% of the nights for more than 4 h per night.

Conclusion: We found a high prevalence of OSA among all of the patients with fibrotic DPLD (not only IPF). Despite certain difficulties, it was possible to achieve good APAP compliance in these patients.

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Source
http://dx.doi.org/10.29390/cjrt-2018-005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422053PMC
August 2018
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