Sleep-Disordered Breathing in Pediatric Cystic Fibrosis

University Of Michigan At Ann Arbor, Ann Arbor MI

Investigators

Linked publications, trials & patents

Abstract

Project Summary/Abstract: Sleep-disordered breathing (SDB) is both common and consequential among children. Adverse health effects of SDB include poor mood; maladaptive behaviors such as inattentiveness, impulsivity, and hyperactivity; impairments in learning and memory; and poor glucose control with development of insulin resistance. The frequency of SDB is often particularly high among children with chronic respiratory diseases. One such disease, cystic fibrosis (CF), affects approximately 1 in 3400 live births and approximately 30,000 people in the United States. Although children with CF frequently report sleep complaints that suggest SDB, such as snoring, mouth breathing, frequent awakenings and excessive daytime sleepiness, the true prevalence of SDB in CF remains unknown. Patients with CF are not routinely evaluated for sleep disorders. Despite availability of effective screening tools for SDB, none have been validated specifically among children with CF. This proposal uses a questionnaire-based approach to identify SDB in children with CF, and to assess the impact of SDB on quality of life. Sixty children aged 6-17 years with CF and their parents will be asked to complete an SDB screening tool and two quality of life measures. Parents of an equal number of age-matched, healthy controls will be asked to complete the same SDB screening questionnaire. Results of the screening tool will be communicated to the subjects? physician, who will then make a clinical decision as to whether to pursue further evaluation for the SDB with a sleep-clinic referral. Polysomnographic data and results of pulmonary function testing will be obtained from a review of the medical records from subjects with CF who are referred to the sleep-laboratory after positive SDB symptom screens. Results of lung function testing will be compared between CF patients with and without a polysomnography-confirmed diagnosis of SDB to assess the potential contribution of CF lung disease to the frequency and severity of SDB. Polysomnographic data will also contribute to a subsequent study to validate use of this SDB screening tool in CF. This contribution will significantly improve the care of patients with CF by helping to identify a potentially important risk factor for significant morbidity in these individuals. Successful completion of this work will lead to better identification, and treatment, of SDB in patients with CF. The results will also set the stage for future investigations on the means by which SDB could worsen CF lung disease. Moreover, this award will allow the PI to improve her knowledge and ability relevant to pediatric sleep research, and gain proficiency in clinical research methodology through completion of a Master?s program. The proposed training will occur at the University of Michigan, an institution that is well known for its opportunities and commitment to excellence. The PI will be guided by an outstanding set of mentors, who have substantial knowledge and expertise in clinical research and mentoring and are leaders in the field. This training will leave the PI prepared to establish a highly productive academic career at the intersection of pediatric sleep and pulmonary medicine.