Prognostic Significance of Obstructive Sleep Apnea in a Population of Subjects with Interstitial Lung Diseases

Autor: Debora Valecchi, Elena Bargagli, Maria Grazia Pieroni, Metella Rosa Refini, Piersante Sestini, Paola Rottoli, Andrea S. Melani
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Pulmonary Therapy, Vol 9, Iss 2, Pp 223-236 (2023)
Druh dokumentu: article
ISSN: 2364-1754
2364-1746
DOI: 10.1007/s41030-023-00215-1
Popis: Abstract Introduction Obstructive sleep apnea (OSA) is often observed in subjects with interstitial lung disease (ILD). It may have a negative impact on the course of ILD, but its prognostic significance in relation to other known indicators of poor outcome is unclear. Methods After a detailed work-up, including overnight unattended type III polygraphy, all subjects newly diagnosed with ILDs referred to our clinics were followed-up for at least 1.5 years or until death or progression of disease [> 10% decline in forced vital capacity (FVC) below baseline]. We analyzed relationships between some prespecified variables of interest, including sleeping results, to establish parameters predictive of progressive course. Results Our population consisted of 46 subjects (mean age 59.6 years; males 61%); 23.9% and 41% had idiopathic pulmonary fibrosis and ILD associated with systemic diseases, respectively. Mean baseline forced vital capacity and diffusion capacity of carbon monoxide were 83% and 57% of predicted, respectively. Mean (± SE) Apnea–Hypopnea Index (AHI) was 17 (± 3) events/h. AHI in the ranges 5–14.9, 15–29.9, and ≥ 30 was recorded in 14 (31%), 6 (13%), and 9 (20%) subjects, respectively. Mean distance covered in the 6-MWG walk test (6MWT) was 302 (± 19) m and 26 subjects (57%) showed exertional oxyhemoglobin desaturation. The median follow-up was about 18 months. Multivariate logistic regression analysis showed that exertional desaturation (HR 8.2; 1.8–36.5 95% CI; p = 0.006) and AHI ≥ 30, namely the threshold of severe OSA (HR 7.5; 1.8–30.6; p = 0.005), were the only independent variables related to progressive disease course. Conclusion We conclude that exertional desaturation and elevated AHI had independent negative prognostic significance in our ILD population.
Databáze: Directory of Open Access Journals
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