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Síndrome da apneia obstrutiva do sono na fibrose pulmonar idiopática: a prevalência num centro de referência
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A fibrose pulmonar idiopática é a mais comum das pneumonias intersticiais idiopáticas. Trata-se de uma doença fibrosante, que envolve exclusivamente os pulmões, de carácter progressivo e irreversível, e que apresenta uma sobrevida média de 2-3 anos após o diagnóstico. A síndrome da apneia obstrutiva do sono é a mais comum das doenças respiratórias do sono, com uma prevalência estimada de 6-17% na população geral, sendo ainda mais comum nos doentes com patologia do interstício pulmonar. Nos doentes com fibrose pulmonar idiopática, a prevalência da síndrome da apneia obstrutiva do sono varia entre os 56,5 e os 88,9%, nos diferentes estudos publicados. Em Portugal, não existe nenhum estudo publicado sobre a prevalência de síndrome da apneia obstrutiva do sono em doentes com fibrose pulmonar idiopática. Objetivo: Pretende-se determinar a prevalência de síndrome da apneia obstrutiva do sono em doentes com fibrose pulmonar idiopática acompanhados num hospital terciário. Em segundo plano, a caraterização
funcional desse grupo de doentes e determinar a sensibilidade dos questionários de screening STOP-BANG e Escala de Sonolência de Epworth. Metodologia: Foram incluídos 23 doentes com fibrose pulmonar idiopática, que realizaram estudo do sono de nível III, prova de função respiratória, prova de marcha de 6 minutos e responderam a questionários
como STOP-BANG, Escala de Sonolência de Epworth e Índice de Pittsburgh. Resultados: A prevalência de síndrome da apneia obstrutiva do sono entre os participantes foi de 100% com predomínio da apneia ligeira. Apresentaram predominantemente alteração ventilatória restritiva ligeira, com ligeira diminuição da capacidade de difusão. O índice de apneia e hipopneia não se correlacionou com nenhum parâmetro funcional respiratório, contudo o índice de apneia e o índice da apneia obstrutiva apresentaram correlação com o volume de ar expirado no primeiro segundo. Conclusão: A síndrome da apneia obstrutiva do sono é frequente em doentes com fibrose pulmonar idiopática, pelo que a prescrição do estudo do sono deve ser considerada na avaliação inicial da doença.
Idiopathic pulmonary fibrosis is the most common of the idiopathic interstitial pneumonias. It is a fibrosing disease that exclusively affects the lungs, is progressive and irreversible in nature, and has an average survival rate of 2-3 years after diagnosis. Obstructive sleep apnea syndrome is the most common of sleeprelated respiratory disorders, with an estimated prevalence of 6-17% in the general population, and is even more common in patients with pulmonary interstitial disease. In patients with idiopathic pulmonary fibrosis, the prevalence of obstructive sleep apnea syndrome ranges between 56,5% and 88,9%, according to various published studies. In Portugal, there is no published study on the prevalence of obstructive sleep apnea syndrome in patients with idiopathic pulmonary fibrosis. Objectives: The aim is to determine the prevalence of obstructive sleep apnea syndrome in patients with idiopathic pulmonary fibrosis followed at a tertiary hospital. Additionally, to functionally characterize this group of patients and assess the sensitivity of the STOP-BANG screening questionnaire and the Epworth Sleepiness Scale. Methodology: Twenty-three patients with idiopathic pulmonary fibrosis were included, all of whom underwent a level III sleep study, pulmonary function testing, six minutes walking test and completed questionnaires such as STOP-BANG, the Epworth Sleepiness Scale and the Pittsburgh Index. Results: The prevalence of obstructive sleep apnea syndrome among participants was 100%, with a predominance of mild apnea. They predominantly presented mild restrictive ventilatory impairment, with a slight decrease in diffusion capacity. The apnea-hypopnea index did not correlate with any respiratory functional parameter; however, FEV1 showed a correlation with both the apnea index and the obstructive apnea index. Conclusion: Obstructive sleep apnea syndrome is frequent in patients with idiopathic pulmonary fibrosis; thus, the prescription of sleep studies should be included in the initial evaluation.
Idiopathic pulmonary fibrosis is the most common of the idiopathic interstitial pneumonias. It is a fibrosing disease that exclusively affects the lungs, is progressive and irreversible in nature, and has an average survival rate of 2-3 years after diagnosis. Obstructive sleep apnea syndrome is the most common of sleeprelated respiratory disorders, with an estimated prevalence of 6-17% in the general population, and is even more common in patients with pulmonary interstitial disease. In patients with idiopathic pulmonary fibrosis, the prevalence of obstructive sleep apnea syndrome ranges between 56,5% and 88,9%, according to various published studies. In Portugal, there is no published study on the prevalence of obstructive sleep apnea syndrome in patients with idiopathic pulmonary fibrosis. Objectives: The aim is to determine the prevalence of obstructive sleep apnea syndrome in patients with idiopathic pulmonary fibrosis followed at a tertiary hospital. Additionally, to functionally characterize this group of patients and assess the sensitivity of the STOP-BANG screening questionnaire and the Epworth Sleepiness Scale. Methodology: Twenty-three patients with idiopathic pulmonary fibrosis were included, all of whom underwent a level III sleep study, pulmonary function testing, six minutes walking test and completed questionnaires such as STOP-BANG, the Epworth Sleepiness Scale and the Pittsburgh Index. Results: The prevalence of obstructive sleep apnea syndrome among participants was 100%, with a predominance of mild apnea. They predominantly presented mild restrictive ventilatory impairment, with a slight decrease in diffusion capacity. The apnea-hypopnea index did not correlate with any respiratory functional parameter; however, FEV1 showed a correlation with both the apnea index and the obstructive apnea index. Conclusion: Obstructive sleep apnea syndrome is frequent in patients with idiopathic pulmonary fibrosis; thus, the prescription of sleep studies should be included in the initial evaluation.
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fibrose pulmonar idiopática síndrome da apneia obstrutiva do sono avaliação funcional respiratória idiopathic pulmonary fibrosis obstructive sleep apnea pulmonary function pneumonia intersticial idiopática idiopathic interstitial pneumonia