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(Chest. 2005;127:1593-1599.)
© 2005 American College of Chest Physicians

Cystic Fibrosis Patients Have Poor Sleep Quality Despite Normal Sleep Latency and Efficiency*

Larry Jankelowitz, MD; Kathryn J. Reid, MD; Lisa Wolfe, MD; Joanne Cullina, MD; Phyllis C. Zee, MD and Manu Jain, MD, FCCP

* From the Departments of Medicine (Drs. Jankelowitz, Wolfe, Cullina, and Jain) and Neurology (Drs. Reid and Zee), Division of Pulmonary and Critical Care Medicine, Northwestern University Medical School, Chicago, IL.

Correspondence to: Manu Jain, MD, Assistant Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University, 240 East Huron St, McGaw Pavilion second floor, Chicago, IL 60611; e-mail: m-jain{at}northwestern.edu

Study objectives: Cystic fibrosis (CF) patients may be predisposed to poor sleep quality due to upper and lower airway abnormalities and impaired gas exchange. Previous sleep investigations of CF patients using single-night polysomnography have reported conflicting results. We hypothesized that sampling sleep for a prolonged period in a patient’s normal environment may give a more representative assessment of sleep quality than a single-night polysomnogram, and that impaired sleep quality would correlate with pulmonary disease severity and self-assessed sleep quality.

Design: Using wrist actigraphy, we measured sleep quality in clinically stable CF patients and age-matched control subjects. In addition, each CF patient and control subject completed the following three questionnaires: the Epworth sleepiness scale; the Pittsburgh sleep quality index (PSQI); and the Medical Outcomes Study 36-item short form.

Results: Twenty CF patients and control subjects were enrolled in the study, and were well-matched for age, sex, and body mass index. The mean (± SD) FEV1 for CF patients was 61.0 ± 20.1% predicted. CF patients and control subjects had similar sleep duration, sleep latency, and sleep efficiency. However, CF patients had higher PSQI scores (6.45 vs 4.55, respectively; p = .04), a higher fragmentation index (FI) [31.72 vs 18.02, respectively; p < 0.001], and less immobile time (88.87 vs 91.89, respectively; p = 0.02). There was a significant correlation of FI with FEV1 and PSQI scores.

Conclusions: Stable CF patients have disrupted sleep, and sleep disruption may in part be related to the severity of pulmonary disease. In addition, the PSQI may be useful in detecting CF patients with poor sleep quality.

Key Words: actigraphy • cystic fibrosis • fragmentation • Pittsburgh sleep quality index • sleep






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